Sixteen people lost limbs either because they were blown off during the explosions or were amputated later. Others whose limbs were preserved face multiple operations to decontaminate the limbs of debris, The New York Times reported Thursday.
"The idea is to spread out the physiological stress over multiple operations," said Dr. David King, a trauma surgeon at Massachusetts General Hospital.
On April 15, two bombs exploded near the finish line of the Boston Marathon, killing three and injuring more than 260.
For many of the injured, pain management is a challenge, said Dr. Alok Gupta, a trauma surgeon at Beth Israel Deaconess Medical Center. The hospital has been administering oral and intravenous narcotics as well as regional nerve blocks when possible.
Joan Smith, social work services manager at Tufts Medical Center, said nearly all of the 14 Boston Marathon victims who came through the hospital experienced post-traumatic stress disorder that could go on indefinitely.
"I also personally did a lot of work with family members who were trying to be strong for their children but at the same time were falling apart behind closed doors," Smith said.
Dr. Scott Ryan, chief of orthopedic trauma at Tufts, said "the most disturbing thing" for him was knowing his patients were awake after the blasts "and looked down and saw these terrible wounds."
"Most of the time," Ryan told the Times, "patients with that bad injuries, they're from a car accident or motorcycle accident and by the time they get to hospital they're not with it enough to look down and say, 'Oh my God, look what happened to my leg.'"