Saturday, May 28, 2022

Rigid Dressings

John T. Brinkmann, CPO

The following are responses to my question about using rigid dressings.

Thanks to all who responded.

John T. Brinkmann, CPO


I do think they are beneficial as they protect the stump, control edema,


the client an active role during his rehab/healing period. and teach


sock management and awareness of stump volume changes. I use the WU


which is removable.

We haven’t been doing them much recently mostly but if I encouraged

them, the

docs would probably agree.

The only reason not to use is if client is not a candidate for a


or if the suture is draining.

Good Topic John!

I believe the academy will be having a discussion about Ipop in March.

We don’t do it at our VA but I think we should be doing some kind of

Ipop and

will raise these issues next March in our hospital.

I think I am more interested in removeable post op protection/prostheses


<< 1. Are you currently doing any of these procedures? 2. If not, have you been given reasons why the surgeons you work with do not use this procedure? 3. Do you believe that they are a positive step in amputee rehab? Any reasons for discouraging or encouraging its use? >>

1. Yes, Probably 500 over the past 3 years.

2. Many of our surgeons “don’t want to be bothered with it,” but call us


counseling prior to surgery or sometimes after.

3. Absolutely. We have had less flexion contractures. No suture lines


due to impact and earlier fittings, when the patient is compliant.



Could you email me all your replies to me. I have a resident who

will be

doing a report on why or why not rigid dressing are being used. It


if you are dealing with Vascular they do not believe in them, if you are

dealing with Orthopods you do have a better chance with them.

Here at the University of Texas Health Science Center the Resident

Orthopods are being taught that a patient should wake up with a rigid

dressing with a foot and pylon and ready to go. Vascular has a different

philosphy. They want the patient completely healed to before they even


to consider a prosthesis for their patient.

Part of her research is going to try and to reach the Orthopods and

Vascular and General Surgeons to find out what they feel about the rigid

dressing and early walking.


>2. If not, have you been given reasons why the surgeons you work with

>do not use this procedure?

Mostly fear of infection in the closed environment.

>3. Do you believe that they are a positive step in amputee rehab? Any

>reasons for discouraging or encouraging its use?


I believe rigid dressings greatly speed the use of the definitive


by preventing the edema which must be reduced in the preparatory


As a side benefit this control of edema also greatly reduces the

post-operative pain and discomfort experienced be the amputee.



We are trying to convert doctors and prosthetist to using plastic

removable devices (usually with foot and pylon) rather than rigid


Although rigid dressings provide some advantages over ace wraps


of wound and control of contractures) the disadvantage of not being able


check the wound is a serious one that prevents many surgeons from using


(especially in vascular cases). In addition, the MD or CP has to have


skill to apply it properly and it must be taken off and redone every few

days to be effective.

In order to overcome the disadvantages of the Rigid dressing and the

plaster IPOP, Dr. Lew Schon and I developed a universally sized plastic

device called the Air-Limb (which is being sold by Aircast). Our


clinical trials have included over 100 patients with very positive


It is important to note, that no one method is correct for all


surgeries. Patients with poor healing potential should be treated very

conservatively until primary would healing has occurred, otherwise the

doctor, prosthetist or the plaster or plastic device may be blamed for



If you would like more information on the Air-Limb or on our


please send me you address and I will send it to you next week.


John, I work in the South Bay/Los Angeles area where HMOs rule. I have

never seen a rigid

dressing. I asked the boss and he has not seen any for a loong time.

They are apparently

done at some hospitals not others. Probably cost is the factor that puts

if off. From what I

have read they are a positive step toward rehab.


Get unlimited access!

Join EDGE ADVANTAGE and unlock The O&P EDGE's vast library of archived content.


Welcome Back!

Login to your account below

Retrieve your password

Please enter your username or email address to reset your password.

The O&P EDGE Magazine
Are you sure want to unlock this post?
Unlock left : 0
Are you sure want to cancel subscription?