Kiwi: An RRD Innovation

By Miki Fairley

The Kiwi, New Zealand's famed flightless bird, walks around all day. Since he wants amputees likewise to be able to walk around all day, Wallis W.T. Farraday, CP, who also is from New Zealand, decided to name his innovative immediate postoperative prosthesis (IPOP) the "Kiwi." Although he originated the idea, Farraday is quick to note that many others have helped in its development.

Farraday began working on an IPOP when he realized that there was an overwhelming need to protect newly amputated residual limbs from injury. Most amputees suffer falls, and for many this is two or three days after surgery. Such falls can cause complications, especially in diabetic dysvascular amputees, that not only severely delay wound healing but can even necessitate revision surgery.

"With the Kiwi, we've repackaged the postoperative protocols using rigid dressings," Farraday explained. Besides protection, research revealed that rigid dressings promote faster wound healing due to the beneficial effects of total contact and pressure applied in a sterile environment, he added.

There have been several types of IPOPs over the years, Farraday said, and they have been effective when skilled personnel are available to apply them and are able to communicate well with other members of the rehabilitation team. Farraday found that the US Department of Veterans Affairs (VA) has consistently used rigid dressings with pylons as IPOPs. The VA has been largely successful, apparently due to the consistency, continuity, and training provided by its programs.

However, rigid dressings are not used predominantly throughout the world today. Studies suggest that the reasons for this are a lack of health professionals trained in the technique and lack of consistent protocols and continuity of care, Farraday noted, adding, "We also realized that many surgeons and nurses who did rigid dressings had failures, mainly due to not being able to see the wound."

Consistency, Continuity

The Kiwi system is exclusive to Hanger Prosthetics & Orthotics, Bethesda, Maryland, and has a patent pending. Hanger has worked to overcome these problems by developing a protocol and training program to control delivery and ensure that the system is applied consistently throughout the country. Physical therapists and other health professionals have been brought into the program to become the experts in using and troubleshooting the system and as "gatekeepers" for the system in their communities.

"We've been keeping statistics, taking photos, and gathering other information and are planning to publish the results," Farraday said. "We've gotten some great results. The more people become educated about the Kiwi and other rigid dressing and IPOP modalities, the better the results will be."

Benefits

The Kiwi works to protect the wound site and shape the residual limb, assisting postoperatively to control and stabilize soft tissue. RRDs, such as the Kiwi have also been shown to help reduce the length of hospitals stays, accelerate rehab time, prevent flexion contractures, decrease phantom pain and sensation, reduce shear and stress force, and help patients psychologically to feel more empowered.

How It Began

The Kiwi came about when many prosthetists started using silicone liners. Recalled Farraday, "I came across a liner made by Alps that was very stretchy, very forgiving, that really protects the shape that is put into contact with it. I tried it out when a doctor needed a rigid dressing for an amputee two days postoperatively. I put the Alps liner over a soft dressing-and I got the idea for a system of doing this, enclosing the liner and dressing in a shell made of a specific type of fiberglass that would conform to the limb and pre-shape the tissues."

Among others who have especially contributed to the development of the Kiwi are Hugh Panton, CPO; Alistair Gibson, CPO; Lori Pipinich, CP; and Micaha Satterfield, CP, Farraday said.

The Kiwi utilizes a custom-molded wrap technique with a gel liner which provides visual inspection and limb support. Just being introduced is the Kiwi 2, Farraday said, with Kiwi 3-an adjustable snap-on pylon-on the way.

	Flo-Tech: Expanding Options - April 2005 Feature - Exclusively Online
	A New Paradigm of Postoperative Amputation Care - April 2005 Feature
	Focus on IPOPs, EPOPs: Does Early Mobility Benefit Amputees? - April 2005 “Although amputations have been performed for centuries as a lifesaving procedure, the current protocols for care of the person undergoing this life-altering surgical procedure, in some cases, may not reflect the complete and active lifestyle in which the amputee can now engage." Feature

Table Of Contents - April 2005

	Focus on IPOPs, EPOPs: Does Early Mobility Benefit Amputees? “Although amputations have been performed for centuries as a lifesaving procedure, the current protocols for care of the person undergoing this life-altering surgical procedure, in some cases, may not reflect the complete and active lifestyle in which the amputee can now engage." Feature
	Kiwi: An RRD Innovation Feature - Exclusively Online
	Flo-Tech: Expanding Options Feature - Exclusively Online
	A New Paradigm of Postoperative Amputation Care Feature
	OA Knee Bracing Relieves Pain, Reduces Medication Need Feature
	Soldier Gets New Prosthetic Design Josh Olson can never forget the date of October 27, 2003. The young soldier on duty in Iraq was hit by a rocket-propelled grenade and lost his entire leg. An infantry squad leader, Olson knew immediately that the leg was gone, but says, “I was just happy to be alive!” Cutting Edge
	Online Education Technology: What We Have, What We Need Education Outlook
	Independent Networks: Leveling the Playing Field Leading EDGE
	O&P Aids Animals Creature Care
	Saddam's Palace Basement Becomes O&P Lab Global View
	Gary Horton's Goal: Providing a Lifetime of Support for Patients Industry Leader
	Got FAQs? Got FAQs?
	US-ISPO Conference Provides Much Food for Thought Association Spotlight
	CMS Proposes Wheelchair Codes Association Spotlight
	Jason M. Jennings, CPO Profile
	ACPOC/Academy Meeting Opens New Dimension Perspective
	President's Message: Introducing The Academy Today Viewpoints