[Durgical](https://durgical.com/en/) › [DurgiPedia](https://durgical.com/en/durgipedia/) › [Nursing](https://durgical.com/en/nursing/) › [Medical–surgical nursing](https://durgical.com/en/nursing/areas/med-surg/) › Amputation: stump care, positioning against contractures, phantom pain and getting ready for a prosthesis

# Amputation: stump care, positioning against contractures, phantom pain and getting ready for a prosthesis

- Safe practice

After an amputation the nurse protects the wound, shapes the stump, prevents joint contractures, treats phantom pain and supports the person.

Updated Nov 13, 2026

## Key points

- No pillow under the stump: it encourages hip or knee flexion contracture.
- After above-knee amputation, lie prone several times a day if allowed; do not cross the legs or let the stump turn in or out.
- Elastic bandage or shrinker as ordered, rewrapped often without creases, to control swelling and shape the stump.
- Phantom sensation and phantom pain are real and common: assess and treat them.
- Inspect the stump daily, using a mirror at home, and keep it clean and dry.

## What it is

After a limb amputation, nursing care looks after the wound and the residual limb (stump), controls swelling so the stump takes a cone shape that fits a prosthesis, prevents hip and knee contractures that would make walking with a prosthesis hard, and manages pain, including phantom limb pain, which is very common. It also covers safe transfers and the grief, anger or sadness that are normal after losing a limb. In patients with diabetes, good glucose control supports healing.

## What it requires

- Wound care with the dressing ordered, and stump shaping with bandage, shrinker or rigid dressing.
- Positioning and exercises to keep the hip and knee straight.
- Assessment of stump pain and phantom pain.
- Practice of transfers and the walker or wheelchair before discharge.
- Emotional support for the patient and family.

## How it is applied (and why)

- Check the wound and the dressing, and the colour and warmth of the skin of the stump — dark skin, new drainage or bleeding need early action.
- Keep the stump straight lying and sitting, with no pillow under it; use a board below the knee — flexion contractures block walking with a prosthesis.
- Encourage prone lying several times a day after an above-knee amputation, if allowed — it stretches the hip flexors.
- Keep the stump aligned with rolled towels and teach not to cross the legs — rotation and crossing cause deformity and reduce blood flow.
- Apply the elastic bandage or shrinker as ordered, tighter at the end than at the top, and rewrap without creases — this controls swelling and shapes a cone.
- Ask about stump pain and phantom pain separately; give ordered relief plus gentle tapping or massage of a healed stump — phantom pain can be treated.
- Practise transfers and walker or wheelchair use with the team — safe mobility prevents falls on the remaining limb.
- Once healed, wash the stump daily with mild soap, dry it well, do not soak it and inspect it — skin breakdown delays prosthesis use.
- Listen to the patient, involve the family and offer referral if low mood persists — sadness and anger are normal, but depression needs help.

## In nursing practice

- Spreading redness, red streaks, warmth, swelling, pus or a foul smell suggest wound infection.
- Dark or black skin on the stump suggests tissue death and needs urgent review.
- Hip flexion, abduction and external rotation contractures after above-knee amputation, and knee flexion contracture after below-knee amputation.
- Phantom limb pain is common and often neuropathic; mirror therapy is one of the commonly used treatments.
- Swelling left untreated can cause discolouration, blisters or ulcers on the stump.

## Common mistakes

- Putting a pillow under the stump for comfort.
- Leaving the patient sitting for long periods with the hip and knee bent.
- Wrapping the stump with creases or tighter at the top than at the end.
- Dismissing phantom pain as imaginary.
- Not rewrapping the bandage when it loosens or creases.

## Test yourself

Think of the answer, then tap the question to see it.

## Why is a pillow not placed under the stump after a leg amputation?

It keeps the hip or knee bent and leads to flexion contractures that make walking with a prosthesis difficult.

## How is an elastic bandage applied to a leg stump?

Tighter at the end than at the top, without creases, and rewrapped often as ordered, to control swelling and shape a cone.

## Is phantom limb pain real?

Yes. It is common after amputation, is often neuropathic, and is assessed and treated like any other pain.

## Which stump findings must be reported?

Spreading redness or red streaks, warmth, swelling, new drainage or bleeding, a foul smell, fever, or dark or black skin.

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## Connections

## Related 5

- [Wound care and dressings: cleaning and choosing a dressing](https://durgical.com/en/nursing/wound-care-and-dressings-cleaning-and-choosing-a-dressing/)
- [Compression and elastic bandaging](https://durgical.com/en/nursing/compression-and-elastic-bandaging/)
- [Self-concept and body image after illness or surgery](https://durgical.com/en/nursing/self-concept-and-body-image-after-illness-or-surgery/)
- [Patient positions: Fowler, supine, lateral, prone and others](https://durgical.com/en/nursing/patient-positions-fowler-supine-lateral-prone-and-others/)
- [Transfers: bed to chair, bed to stretcher and mechanical lifts](https://durgical.com/en/nursing/transfers-bed-to-chair-bed-to-stretcher-and-mechanical-lifts/)

## Related conditions 3

- [Acute limb ischaemia](https://durgical.com/en/conditions/acute-limb-ischaemia/)
- [Diabetic foot](https://durgical.com/en/conditions/diabetic-foot/)
- [Peripheral artery disease](https://durgical.com/en/conditions/peripheral-artery-disease/)

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Educational content for students; it does not replace your institution's protocols, supervised clinical training or a prescriber's order. Dose-calculation examples use made-up numbers: they are educational, not a clinical order.

Sources: [Leg amputation - discharge, MedlinePlus Medical Encyclopedia](https://medlineplus.gov/ency/patientinstructions/000014.htm) (MedlinePlus, US National Library of Medicine, 2026); [Choo YJ, Kim DH, Chang MC. Amputation stump management: a narrative review. World J Clin Cases 10(13):3981-3988](https://pmc.ncbi.nlm.nih.gov/articles/PMC9131228/) (World Journal of Clinical Cases (PubMed Central, open access), 2022).

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Representative model, for educational purposes only.

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Source: https://durgical.com/en/nursing/amputation-stump-care-positioning-against-contractures-phantom-pain-and-getting/
License: CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). Cite as: DurgiPedia (durgical.com), https://durgical.com/en/nursing/amputation-stump-care-positioning-against-contractures-phantom-pain-and-getting/