A Manual for Above-Knee Amputees
Fitting the Prosthesis
In general, the earlier a prosthesis is fitted, the better it is for the amputee. One of the most difficult problems facing the amputee and the treatment team is edema, or swelling of the stump, owing to the accumulation of fluids. Edema will be present to some extent in all cases, and it makes fitting of the prosthesis difficult, but certain measures can be taken to reduce the amount of edema.
The use of a rigid dressing seems to control edema. After the rigid dressing has been removed and when a prosthesis is not being worn, elastic bandages are used to keep edema from developing. The amputee is taught the proper technique for bandaging and is generally expected 'to do this for himself as shown on the next page.
For the average adult two or three elastic bandages six inches wide are used. During application, the bandages should be stretched to about two-thirds of the limit of the elastic, and the greatest tension should be around the end of the stump.
The stump should be kept bandaged at all times, but the bandage should be changed every four or six hours. It must never be kept in place for more than 12 hours without rebandaging.
If throbbing should occur, the bandage must be removed and rewrapped. Edema occurs rapidly when the stump is left unbandaged so it is very important to replace the bandage without delay.
Special elastic "shrinker" socks are available for use instead of elastic bandages, and while not considered by some to be as effective as a properly applied elastic bandage a shrinker sock is better than a poorly applied elastic bandage.
Whether elastic bandage or shrinker sock is used, it should be removed at least three times daily and the stump should be massaged vigorously for 10-15 minutes. The bandage or sock must reapplied immediately after the massage.
- Begin by placing one end of a rolled 6-inch wide elastic bandage on the upper part of the thigh and wrap it around the stump toward the rear.
- Bring the roll through the legs and over the end of the front of the thigh.
- Bring the roll across the back and on across the lower stomach area.
- Continue to wrap around the thigh, across the back and lower stomach area until the roll is suspended. Attach the end of the roll with the metal clips that are included with the bandage.
- With a second roll of elastic bandage, begin to wrap the stup from the upper outer surface diagonally toward the lower inner surface.
- Bring the roll of bandage around the back of the stump and upward diagonally.
- Bring the roll of bandage behind the uper part of the stump.
- Continue to wrap the stump in an overlapping fashion until the entire stump is covered. Fasten the end of the second roll of bandage to the first bandage.
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Copyright 1996 - Alvin L. Muilenburg and A. Bennett Wilson, jr.
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