Herewith the replies to my query >Anyone able to list a few specific
contraindications for 3-s system or at
>least point me at a website where I can read same please? Thankyou to all
who responded. This kind of feedback does assist a bloke to make his own
decisions based on the experiences of his colleagues.
>Richard Ziegeler (P&O)
I have been using the 3/S system using custom Durr-Fillaur locking system
for over 10 years. It helps the limb heal, protects the limb from improper
donning, and when the patient does not following instruction. My old
patients would die if asked them to use socks against their skin. We even
use it on most AKA. There are some tricks to having it work, but it is
pretty easy. Socks cause revisions and abrasions that don’t need to
happen.
John G. Russell Jr.
3161 Putnam Blvd.
Pleasant Hill, CA. 94523
Phone 510-943-1119
Fax 510-943-24-93
Dear Mr. Ziegeler,
Some of the contraindications for 3-S that I can recall are:
1) Upper Extremity Involvement such as severe arthritis or upper extremity
prosthetic use
2) Excessive Perspiration that does not dissapate over time of wear
3) Unacceptance of distal end “milking” action of the residuum
4) Skin that breaks down easily with exposure to silicone
5) Deeply invaginated scars or muscle bunching that can break suction seal
6) Highly conical, bony, and short residual limb shape
I am sure there are more but these might give you a start.
Sincerely,
Gerald Stark, BSME,CP
Fillauer, Inc.
I have had a lot of success with the Fillauer 3-S and Ossur Icex systems.
Some things to watch out for are invaginated scars, adherent tissue or
other skin sensitivity. Conical or extremely prominent tibia can pose a
problem if the
correct system is not used. I would recommend the Iceross liner w/distal
cup for many of these situations. Hydrostatic or total surface bearing
sockets work well for most. Use your judgment or call for technical support
at Ossur.
Speak with either Hans Schaeffer or Jan (Yan) Christenson. Hope this helps.
Ryan Gatlin
Hi Richard,
By the 3-system do you mean the silicone liners in themselves or the other
parts of the system such as the locking method (ie
shuttle-lock/lanyard/loop and pin)?
Also do you mean this particular system by this manufacturer (about which I
know next to nothing) or does the question apply equally to ALPS or Ossur
systems (both of which I have used a fair bit)?I’ll be happy to help if I
can.
Cheers,
Grant Crosthwaite
Richard Some off-the-top-of-my-head contraindications for 3 S system:
VERY low tolerance to distal contact
Mobile, redundant distal tissue (difficulty donning)
Upper extremity limitations (poor manual dexterity, arthritis or
amputation)
No room for the shuttle lock (long residual limb)
Allergy to silicone or other sleeve materials
Open residual limb wound
Poor hygeine habits
High cost for purchase and/or replacement
Some long time sock wearers just don’t like the feel of the gel sleeves
I hope this smattering of information/experience is helpful. Good luck!
Dave ———————————-
DMProcter, CPO
OmniCare Labs
Some say that people with compromised skin, say envaginated scars or burn
scars, may not be candidates for 3-S-type systems. I think proper socket
fit and use of the liner best for the person, eg OWW Alpha, ICEROSS
Comfort Plus, the new TEC with pin, etc, is key.
Some complain of distal pistoning. That results from liners chosen too big
for the residuum, lack of an air seal between socket and liner (a
semi-hypobaric fit on outside of the liner as well as inside is a real
plus), or improper socket fit. As for the air seal, I believe the latches
by Ortho Europe (see www.ortholite.co.uk), which I think are the best, are
now supplied with o-ring seals on the latch pins for semi-hypobaric fit.
I’m working to confirm that….
I personally favor the thicker liners, like the 9mm Alpha and the thick
Comfort Plus. Thin liners, like the old ICEROSS and Aegis have too little
padding and aren’t as forgiving of volume changes. I use both a full
length and shortened Alpha 9mm Uniform liners. Talk about cushioning!
Chris Johnson, Engineering Director,
College Park Industries, Inc.
www.college-park.com
