<img style="float: right;" src="https://opedge.com/Content/OldArticles/images/2005-04_16/therealbob.jpg" hspace="4" vspace="4" /> <b><i>Robert Brown, CPO, FAAOP, went to an amputee's home, in 1993, to cast and measure a patient for a preparatory prosthesis. As hospitals usually did then, the hospital had sent the patient home with practically no limb protection. Brown found him sitting on the floor to go up a flight of stairs. The patient had fallen and injured his residual limb sometime earlier.</i></b> Brown then made the Flo-Tech® postoperative prosthetic limb protector. Later the patient said, "I should sue the hospital." When Brown asked why, he answered, "They should have sent me home with this in the first place." Brown told him that he was the first person to have this, and the patient joked, "Well, then, you should name it after me." Brown and his wife Kathy founded Flo-Tech O&P Systems, Trumansburg, New York, in 1987, when they realized Brown was constantly using his uniquely designed prosthetic and orthotic systems for patients. Like other immediate and early postoperative prostheses (IPOPS and EPOPs), Flo-Tech's devices protect the limb and the surgical wound, help control edema, and promote healing. Since they are easily removable, there is always access to the wound. The devices are much easier to don and doff than a plaster cast. Flo-Tech provides a wide variety of prefabricated options and is working on adding more different shapes and sizes to accommodate more needs, said Brown. Flo-Tech's APOPPS<sup>TM</sup> (an acronym for "Adjustable Postoperative, Protective and Preparatory System) is available for transtibial amputees, and a transfemoral version, the APOPPS-TF<sup>TM</sup>, also is offered. "We can do anything custom," Brown adds. This includes custom sockets for Symes, knee disarticulation, upper-limb, and also jointed systems and sockets with shuttle lock suspension. The company is working on expanding options for these in prefab versions as well, and offers 24-hour delivery in most cases, Brown said. <h4>APOPPS Advantages</h4> <img style="float: right;" src="https://opedge.com/Content/OldArticles/images/2005-04_16/bobby3.jpg" hspace="4" vspace="4" /> The APOPPs offers advantages over plaster casts in that the devices are faster to apply and produce consistent results. For instance, Brown remembers that when he was doing plaster casts in a hospital, situations would arise when the patient woke up and inadvertently distorted the cast. The nurse or other assistant sometimes wouldn't be strong enough to keep the patient's leg up, and the cast would flatten as the leg was lowered. However, prefab systems always keep the same shape. A plaster cast generally tapers down distally, but the APOPPS is more cylindrical and thus better prevents damage to the limb in case of falls, Brown noted. There have even been patients weighing 300 lbs or more who have suffered falls with no damage to the residual limb. The APOPPS system saves the prosthetist considerable time. "It takes only about five to 15 minutes to put on our system," Brown points out, "whereas a plaster cast can take up to an hour. Also, the prosthetist doesn't have to wait around in the operating room; he can fit it later in the recovery room or the patient's room." Pressure force location is another factor. "Distal anterior-posterior pressure is what tends to cause the suture line to split, but with our system, about 85 percent of the pressure is from the medial-lateral area," Brown adds. The APOPPS is easy to don and doff. "The APOPPS opens up like a clam shell," Brown explains. To close it, "One strap, two soft neoprene bands-and you're done!" After being shown how to use the APOPPS, an amputee with diabetic neuropathy in his fingers was able to easily don the system on his first attempt, Brown said. The APOPPS is made of polypropylene, but is very versatile as to other interfaces. Patients can use Ace wraps, shrinkers, prosthetic socks, or other interfaces such as gel liners. <h4>Sees Demand Growing</h4> Brown believes that the demand for postoperative protective systems will grow, since he notes that about six out of every ten amputees suffer injuries to their residual limbs (ranging from minor wound separation to major impact damage, causing additional hospital stays and even surgeries. "I can see in the future Medicare and insurers demanding that patients be fit with these protective devices. I can see hospitals wanting help from professionals to have stock available and be able to fit them on a moment's notice." <i>For more information about Flo-Tech, visit <a href="https://opedge.com/2855">www.1800flo-tech.com</a></i>
