An older adult client has a lower-extremity amputation due to peripheral vascular disease. The nurse elevates the residual limb and administers pain medication. Which condition is associated with the highest morbidity for this client?

An older adult client has a lower-extremity amputation due to peripheral vascular disease. The nurse elevates the residual limb and administers pain medication. Which condition is associated with the highest morbidity for this client?

• A. Phantom limb pain
• B. Surgical site infection
• C. Deep vein thrombosis
• D. Osteomyelitis

Answer: (B)

In this scenario, the most impactful issue is infection at the surgical site. After an amputation, especially in an older adult with peripheral vascular disease, tissue perfusion is compromised and healing is slower. A wound infection can lead to prolonged hospitalization, delayed or multiple additional surgeries (debridement or revision), impaired stump healing, delay in prosthesis fitting, and in severe cases, sepsis. These outcomes contribute to higher morbidity and can significantly affect function and survival. Phantom limb pain is common and bothersome but does not typically carry the same level of morbidity as an infected wound. Deep vein thrombosis is a serious risk, particularly with immobility, but with preventive measures and early mobilization its impact is typically less than that of a wound infection in this patient group. Osteomyelitis is serious when it occurs, but it is less common after amputation than superficial or deep surgical-site infections, and its occurrence usually requires preexisting infection or contamination. Thus, surgical site infection represents the complication with the greatest potential for morbidity in an older adult with vascular disease undergoing limb amputation.

In this scenario, the most impactful issue is infection at the surgical site. After an amputation, especially in an older adult with peripheral vascular disease, tissue perfusion is compromised and healing is slower. A wound infection can lead to prolonged hospitalization, delayed or multiple additional surgeries (debridement or revision), impaired stump healing, delay in prosthesis fitting, and in severe cases, sepsis. These outcomes contribute to higher morbidity and can significantly affect function and survival.

Phantom limb pain is common and bothersome but does not typically carry the same level of morbidity as an infected wound. Deep vein thrombosis is a serious risk, particularly with immobility, but with preventive measures and early mobilization its impact is typically less than that of a wound infection in this patient group. Osteomyelitis is serious when it occurs, but it is less common after amputation than superficial or deep surgical-site infections, and its occurrence usually requires preexisting infection or contamination.

Thus, surgical site infection represents the complication with the greatest potential for morbidity in an older adult with vascular disease undergoing limb amputation.