Management Of Amputation Stump.pptx

Management Of Amputation Stump

1. Management Of Amputation Stump By Dr Fairuz Khamzah

2. Overview Post Op Mangement Pre Prosthetic Rehab Edema Prosthetic fitting Choices of dressing type Summary

3. What is needed in post op management? - Multi-disciplinary team Optimal recovery and rehabilitation after amputation requires a multi-disciplinary approach. It is important that all personnel involved in the treatment of the amputee, obtain knowledge of each others professions and working procedures. Occupational therapist Prosthetist Rehabilitation Consultant Physio - therapist Nurse Orthopaedic surgeon The A mputee

4. What is needed in post op management? - Aims Ensure good wound healing Reduce edema in residual limb Pain reduction Shape residuum Protection of residuum from external stresses Prevent contractures Prepare for prosthetic management/ambulation

5. Pre Prosthetic Rehab Cardiovascular Training Streghtening Upper Limb and core Balance in standing and sitting Early Mobility Transfer into bed Bed to wheelchair Standing Walking

6. Wound Healing - edema Inflammatory response Edema exudate forms Fluids from the medullary bone bleeding, tissue exudate and blood loss form oedema exudate Harmful effects of oedema : Delays wound healing Increases interstitial pressure Increased risk of infection Induces the onset of pain

7. Harmful effects of Edema Amputees often predisposed to edema: Pre existing vessel disease Decreased capacity for venous return Incision to vessels Cut muscles Immobility

8. What do we want? Modelling from club shape to conical shape Reduction of edema

9. The right time for prosthetic fitting.. Volume reduction after transtibial amputation ( Lilja et al 1996)

10. What are the options: Soft dressings: Elastic Bandaging Elastic Stockings/ stump shrinkers Rigid dressings Thigh level rigid plaster dressing without immediate prosthesis IPOP – Immediate Post op Prosthesis Removable Rigid Dressing (RRD) Compression therapy/RRD

11. Soft Dressing Elastic Bandage

12. Soft Dressing Elastic Stocking

13. Rigid Dressing Plaster Of Paris

14. Rigid Dressing Immediate Post op Prosthesis

15. Removable Rigid Dressing Vacum Dressing

16. Compression Therapy Silicon Liner

17. Summary Wound healing as soon as possible Effective treatment of edema Rigid dressing is preferable than non rigid

18. THANK YOU