Purpose: The aim of this case study was to investigate the effectiveness of rigid dressing vs. soft dressing on stump healing in older patients with trans-tibial amputations of dysvascular etiology. Secondary objective to investigate the effects of the use of rigid vs. soft dressings on time to prosthetic fitting, time to independent walking, and length of stay in the hospital. Methods: Followed 68-year-old patient outcomes following L TTA and use of standard soft dressing (shrinker') and conducted literature search/review of current articles pertaining to the efficacy of RD's vs. SD'. Most articles used stump healing as outcomes measures. A total of 8 articles reviewed. Results: There was a trend in favor of rigid and semi-rigid dressing vs. soft dressings for achieving stump healing, reducing edema, and decreasing acute length of stay. No significant difference found in time to first prosthetic fitting or time to independent walking. One study reported a multidisciplinary interim prosthetic program (IPP) found a significant decrease in initial prosthetic casting and independent walking. No statistically significant difference in an increase rate of independent living with the use of rigid dressing as compared to soft dressings. Conclusion: It is difficult to compare research about this topic due to the various outcome measures and the specifics at which researchers define these outcomes (healing time, functional outcome, etc.). There are disadvantages and advantages to both methods for post-operative management, but healing time does appear to increase with the utilization of rigid dressing as compared to soft dressings. Consistency between applications of appropriate dressing is needed but still individualize to patients. RCT's are needed but this may be unethical.
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transtibial amputtee, rigid vs soft dressing, dyvascular, post-operative, outcomes
Coronado, Katherine. "Post-operative management for the older dysvascular transtibial amputee." (2014). http://digitalrepository.unm.edu/dpt/50
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