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Post-Op Programme

A guide to successful fitting of first prosthesis

The Össur Guide aims at outlining the optimum route from amputation to the fitting of prosthesis for transtibial amputees. The guide covers important steps that are believed to have positive impact on the successful rehabilitation of amputees.The aim is for the amputee to be able to return to previous lifestyle in as short amount of time as possible.

A better prosthesis means a better quality of life.

Össur offers a wide range of solutions suitable for different stages in the prosthetic provision of an amputee, from fitting of the first prosthesis to solutions for active lifestyles.

The rehabilitation of an amputee is built upon five important pillars:

  • Multidisciplinary Team
  • Application of Rigid Dressing
  • Compression Therapy
  • Physiotherapy
  • Early fitting of Prosthesis
 

1. ORD

Application of Rigid Dressing for immediate postoperative treatment

Evidence supports the application of a rigid dressing to the residual limb for the first 5-7 days following transtibial amputation.

The aim with the rigid dressing for TT amputees is to:

  • Counteract oedema
  • Prevent contractures of the knee
  • Protect the wound

The Össur Rigid Dressing (ORD) is made out of soft and pliable material and can thus be formed to the residual limb. The dressing is made rigid by creating vacuum in the internal chambers of the product. Containing the residual limb provides protection from discomfort, caused by bed trauma and possible falls during early rehabilitation. The ORD should be applied to the residual limb over wound dressing and appropriate padding material immediately after the operation. The ORD allows for easy wound inspection during early rehabilitation.

Instruction video for Use
and handling Ossur Rigid Dressing

2. Compression Therapy

Postoperative compression therapy after transtibial amputation

Compression therapy should begin when the rigid dressing is removed, 5-7 days postoperatively and continues until the prosthetic fitting. Use of a silicone liner at this early stage is important, as the largest change in residual limb volume occurs during the first weeks after amputation.

The aim with Compression Therapy is to:

  • Standardize the treatment
  • Provide the resiudal limb with a favorable shape for prosthetic fitting
  • Facilitate early mobilization/physiotherapy
  • Speed up the healing processound inspection during early rehabilitation.

Application of a postoperative silicone compression liner allows for the same level of compression to be achieved regardless of who applies the liner. The liner provides equally distributed pressure that decreases proximally. Blood circulation and tissue growth will be stimulated by hydro-active wound care and increased patient mobility. The liner also forms the stump in the shape most applicable for successful prosthetic care. Application of a postoperative silicone liner is simple and reproducible. It may be applied,  after some initial training, by the patients themselves. Iceross Post-Op liners have been used for early compression therapy of transtibial amputees with good documented results since 1997. Iceross contributes to an effective and predictable prosthetic  rehabilitation.

Instruction video for Use and handling of the Iceross Post-Op liner for Compression Therapy

3. Physiotherapy

Physiotherapy following amputation

The goals of physiotherapy following amputation is to give the patient an optimal preparation for prosthetic use and the best possible conditions for an independent life.

Important information following transtibial and transfemoral amputations:

  • Contractures will always have a negative influence on the patients’ chances of becoming a prosthetic walker and must be avoided
  • Increased muscle strength is crucial for patient control of the prosthesis and to facilitate transfers between bed, wheel chair, toilet etc.
  • Increased blood circulation speeds up the wound healing process and improves general health.

It is important to encourage and support the patient to be as active as possible and by explaining the importance of daily mobilization. Perform all exercises and transfers with the Iceross liner applied to avoid oedema When necessary, the liner may be rolled down just enough not to interfere in knee flexion exercises. Always use the residual limb support on the wheelchair. If the residual limb is left without support there is a great risk of contractures as well as oedema forming, which may lead to prolonged wound healing and a delayed rehabilitation.

4. Early fitting of Prosthesis

Prosthetic provision should be promoted at the earliest stage in rehabilitation with the aim of providing the patient with the first definitive prosthesis as soon as possible.

This relies on several factors including the following:

  • Stage of healing
  • Residual limb shape
  • The oedema present
  • Overall physical and physiological state of the patient

The first prosthesis after amputation and successful postoperative treatment can be made as early as after three weeks. The prosthesis is used to substitute a lost limb. This is done for functional and/or cosmetic reasons. Regardless of amputation level, the prosthesis should work as an extension of the skeleton where surrounding soft tissues are used for suspension and force transmission.

When choosing components it is important to consider the ability, health status and aspirations of the patient. For many, it is initially about getting back on their feet and being able to get around comfortably, without getting tired too quickly. After that, people want to get back to work, family life, sport and travel – a Life Without Limitations. Össur understands the technology that can help achieve those things. It also understands people’s aspirations and produces effective, appropriate solutions, both for first prosthesis fitting as well as for the definitive prosthesis.