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Stump shrinkers
are used to reduce, prevent or control swelling (edema)
in the below knee residual limb.
They are designed to fit snugly and apply pressure to
the soft tissues of the stump. |
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The shrinker can be applied
over dressings as necessary. Dressings should be thin
(i.e. a 4x4 opened) in order that they will not affect
the pressure of the shrinker (like a rock in a shoe). |
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It is important that
this pressure be greatest at the end (distally) and gradually
lessens towards the thigh (proximally).
If the shrinker is loose at the lower end (distally) then
the tighter area higher (proximally) can stall circulation
and actually increase swelling (edema). |
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| Turn the shrinker inside
out and stretch it open to contact the end of the stump.
This should minimize any tension on the suture line.
Ask the patient to hold the knee straight and warn that
they will feel a momentary pressure. |
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Stretch the lower half of
the shrinker firmly up towards the knee. Then let the
material relax. This should ensure maximum compression
at the end (distally).. |
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| The top (proximal) half of the
shrinker can now be pulled up into position. This should not
be stretched as much as the lower half. |
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| The shrinker will tend to
slide down and should be checked regularly. The patient
should be instructed whenever possible to make certain
the shrinker is in proper position. |
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Stump shrinkers, like
ace wraps, should apply even pressure that gradually lessens
at the top (proximally). They should always extend past the
knee to minimize window edema at the knee.
Most amputations are the result of poor or otherwise compromised
circulation. In some cases, even light pressure can cause
skin breakdown especially over thinly padded bony prominences
like the patella or cut end of the tibia. If redness or other
signs of excessive pressure are noticed, discontinue use and
contact the physician or prosthetist. |
