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
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
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
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.