IPOP (part 3).pptx

its is about immediate post op. prosthesis care

1. IPOP/IPSF Immediate Post operative Prosthesis/Immediate Post-surgical fitting

2. Rigid dressing components before POP Bandaging Non adherent sterile gauze Fluffed gauze (sterile lamb’s wool) is placed over the distal end to allow wound drainage Lycra spandex sock pulled directly over the residual limb

3. Rigid dressing components before POP bandaging Relief PU-pads for tibia, fibula and their bony ends and heads or any other pressure sensitive area

4. Rigid dressing components with POP Bandaging Stump is positioned in 10 degree of flexion Elastic POP plaster (ACE wrap) Regular plaster with stockinette impregnated POP bandage incorporated safety buckle for connection with Waist belt

5. Immediate Post Operative Prosthesis What is an IPOP? Device applied before wound closure (in case healing by secondary intension is indicated) or after wound closure that protects the suture site and allows limited weight bearing and gait training Immediate Post Operative Prosthesis applied in the Operating Room by prosthetist Bridge between surgery and definitive prosthesis

6. History of IPOP uses Immediate Post-Surgical Prosthetics by ERNEST M. BURGESS; Orthopaedic and Prosthetic appliances Journal,1967-02-105

7. Application of IPOP

8. IPOP uses Lower Extremity can be custom fabricated or prefabricated Upper Extremity can be external power or body powered can be used on all levels, but best results at the tran -radial level and trans-tibial level

9. Advantages Most importantly, helps patient with phantom limb sensation, as they can see a leg Reduces severity of phantom limb pain Positive psychological attributes of seeing leg. Patient with transtibial and knee disarticulation may bear weight, using an assistive device, 5-21days following surgery Usually 20 lb or 10 kg of weight is enough for bearing on IPOP, to begin with Maintenance of lower and upper limb strength, trunk balance Physiological standing advantage, maintaining cardio-vascular status Prevent contracture, Shorter hospital stay, shorter recovery time Quicker identification of patient’s activity level

10. Limitations Lack of easy inspection Excessive post-operative edema Lack of 45 days of pre-operative ambulation

11. Comparison between conventional post operative management and IPOP Soft dressing Semi-rigid dressing Removable rigid dressing (RRD) Removable Semi-rigid dressing Rigid dressing IPOP Air Splint

12. Application ( Air Splint) Non custom IPOP are available, these are light than fiberglass or plaster, contain air bladder which can be inflated to accommodate the size of residual limb. Its advantages are that it can be easily removed so that wound inspection is easy. Therefore non custom IPOP are very much useful in diabetic and PVD cases. “Air-splint” was originally designed for emergency to stabilize fracture site.

13. Parts of Air Splint Weight bearing frame with distal end adopter Transfemoral Pneumatic cover

14. Parts of Air Splint Pneumatic end bearing cover End bearing cushion

15. Air splint (application) Application Patient wears a sock on the residual limb to absorb moisture and prevent skin maceration Air splint is applied and zipped to secure it arround the residual limb A hose is attached to pump A distal to proximal measured pressurization occur as the bladder is inflated to a pressure of 25mm of hg with the pump. Finally the hose is disconnected More air is added as edema subsides

16. Advantage and limitation Advantages Easy inspection of incision site Provision for drainage Provision for uniform pressure distribution Ease of use and removal Usually applied 2-10 days after amputation Partial bearing is possible with air splint, which helps in balance training Continuous support and protection Reduces occurance of hematoma Limitation Build up of heat in warm climate Difficult weight bearing

17. Silicone liner Its applied by inverting and than rolling it over the residual limb and hence less traumatic Disadvantages are that its not good for weight bearing and build-up of heat

18. Thank you