Amputation in and of itself, from the scientific and life aspect, is considered a disability, and amputation is considered a war injury and a disability in which the affected individual goes through multiple stages that change the system of feeling security and peace for the amputee (1). Amputation rates vary by country, ranging from 1.2 to 4.4 per 10,000 inhabitants (2) (3), The bulk (up to 90%) of cases affect the lower limbs. By 2050, these figures are predicted to more than treble (4). Amputation causes a number of restrictions on one's ability to engage in social, professional, and recreational activities. (5). Amputation is frequently an unavoidable treatment in the advanced stages of various diseases, including accidents, war, diseases as diabetes mellitus (DM), peripheral artery occlusive disease, cancer disorders, trauma, or infection, and has a significant impact on a patient’s life (6).

The image of the body is a mental image that the individual forms of his body, whether in its external appearance or in its internal components and its various organs and its ability to employ these organs and prove their efficiency and the accompanying feelings or positive or negative attitudes about those mental images of the body (7). Quality of life is defined by the World Health Organization as ”the individual’s assessment of their place in the conditions of the culture and values in which they live, as well as in connection to their objectives, expectations, principles, and interests.” Demographic and health characteristics have been shown to influence quality of life and self-esteem in many domains of human existence, including physical, mental, spiritual, and social dimensions (8) (9).

BI is a dynamic and complex process that describes a person’s individual impression of his or her own body. Internal elements such as age, gender, and physical condition influence this perception, as do external factors such as social or environmental circumstances (10). SE is a favorable or negative attitude toward oneself: an overall evaluation of one’s own worth or value. SE includes beliefs and emotions including triumph, misery, pride, and humiliation (11). Therefore, thus present study aimed to investigate the body image (BI) and self esteem (SE) among patients with amputation at Kut City middle Iraq.

According to our findings, most of the study participants were men, aged (50-59) years. The lower limbs of patients have recorded the highest amputation site and caused by the wars for more than ten years.

The current results come because the male was share in war and in our society, male considered all the repossibilities of work so he is at risk of amputation, while females are have amputation due to congenital conditions or other defects.

The war records the highest percentage among the causes of amputation; The majority of the participants were elderly because the most of the wars had already ended. The investigation that was applied on 42 patients who had lower limb amputations corroborated our findings. (13).

The results revealed that (78%) of the amputees showed poor perception of body image and that (57%) of them showed low self-esteem (table 2). These findings are due to the fact that amputation is a permanent surgery that leaves no residual body parts, which raises questions in cases of amputation due to uncertainty over the appropriateness of compensation for the amputee's lost body parts.

Many studies confirmed that low self-concept of the individuals with disabilities in the upper and lower peripheral exhibit heightened problems, particularly in terms of worries, feelings of guilt, and self-concept. (14).

The study results illustrate that the body image may affect self-esteem and correlated (positive) (r=0.574; p=0.000).

The investigator attributes the existence of this association to the fact that one's perception of one's body has an effect on one's sense of self-worth. In other words, the more negatively one perceives one's body, the lower one's self-esteem will be, and vice versa. This relationship is expected given that one's perception of one's body is linked to future optimism and aspirations.

Given that amputation is a permanent procedure that prevents the amputated portion from growing back, amputees may feel inferior because there is no assurance that the compensation for the amputated part is sufficient. (15).

The conclusions lead to the case of amputation before the person is affected by the understanding of the individual to self-acceptance, and they assisted in maintaining this opinion as a result of the amputation. As a result, the individual in the case of monitoring and evaluating themself is known as ''contemplating'' the state of the individual that develops low self-concept of the individual on the case anxiety that resulted in the amputation of the restraint.

This outcomes are agree with a study that done in Australia to assessed body image and self-esteem. The study found that amputation of the lower limbs had a considerable impact on the patient’s body image. Self-esteem appears unaffected by the lower limb amputation, on the other hand. However, a feeling of phantom pain has a significant impact on one's self-esteem. Medical professionals thought that this condition was connected to a psychological issue. (16).

Past Studies have established that there is a relationship between BI and SE and that there is a clear effect of BI on anxiety among individuals in general and specially in an amputee patients, as they confirmed that the image of the body has a clear effect on influential what the future is, making the person more anxious and isolated, because amputation is considered a disability phenomenon, It causes the person's body image to be distorted, and the new body image makes the person more erratic than his healthy peers, resulting in emotional disorders and social isolation. (17).

It was behind BI estimation, the self-identity changes after the appearance of an amputation of the lower body limbs that affect performance, there by weakening all patients in different levels of education, leading to undesirable expectations about them in the future (18).

The Limb Phantom phenomenon, which is also known as the anxiety-inducing belief that the amputated limb is still there and still feels, is supported by this. This phenomena directly harms the individual and strengthens anxiety in this area, playing a definite role. (19) (20).

The current analysis reflects that amputated patients were Negative self-perception results in low self-esteem. To increase the possibility of early intervention, hospitals need to have specialists in mental health and psychological therapy. in these instances and to guide amputation cases to reduce psychological issues. Additionally, offer programs to help amputation patients in order to lessen the psychological issues associated with amputation.