I want to thank all those that responded to my E-mail about ischemic pain
in a bk socket. I will also quickly summarize the responses. There were
many great responses but two socket designs ran away with the top spot(s):
#1 Elevated Vacuum
This was by far the most popular choice. The advice that seemed to
resonate was to make sure the gel liner was a perfect fit. It was also fun
to see that there were very different opinions on which type of gel to use;
many said TPE only, others said looser fitting silicon…. (Not many in
the Vac camp mentioned their means of vacuum, or their tension mmhg goals)
#2 Thigh joints and lacer. Many reported being able to move a great deal
of pressure proximal (to an area with health blood flow), and being able to
run a much looser socket.
I think the biggest take away was that many different designs have worked,
and some that work for many patients have not worked for all. Many have
tried vacuum, and have failed. Many have gone old school with p-lite and
or thigh joints and lacer…. and failed. There does not seem to be one
“recipe” to eliminate this issue, but diligence and being willing to try
multiple approaches seem to ultimately find good results. Many of the
replies also spoke to a different set of goals for this type of client.
Many said their goal was just extending the amount of time between
applying the socket and having to sit- With some clients only being able
to walk for 15-30 min before needing to get off the limb (15-30 in many
cases was considered a huge victory!). I also read some responses that
were brutally honest, and spoke to the idea that no socket could be
comfortable for some clients, and that further amputation can in many
instances be the only answer.
Thanks for all the responses! Again, i am truly impressed by this
community, and their willingness to share information, and experiences.
Have great day!
Justin Tegerstrand CPO