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The PSRD protects a below-knee or above-knee
stump from any inadvertent trauma, i.e. a fall or a collision. The
PSRD may also help control stump swelling.
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The PSRD is worn over the proper
number of stump socks to maintain a comfortable and snug fit. |
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Wound dressings should
be kept to minimal thickness, to keep any open areas clean
and absorb any drainage before it could stain the stump sock.
(Dressing thickness will increase pressure in the socket.) |
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The figure- 8 strap
is wrapped proximal to the patella, then around the posterior
side of the knee and extending anteriorly again and proximal
to the patella before it is fastened in the snap buckle. (This
should be snug enough to keep the dressing from slipping off.) |
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Unless otherwise specified, the PSRD
should be worn when the patient is up and about. The patient
may wear the PSRD in bed in order to either control edema
(in place of an ace bandage) or if there is further risk of
injury. |
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The PSRD should be cleaned regularly.
Both the low-density polyethylene and closed cell foam can
tolerate soap and water, as well as any alcohol-based disinfectant
or cleaner. Any cleaning residue should be rinsed off completely
and dried with a clean towel. |
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The stump should be inspected regularly
for any irritation caused by the PSRD. Excessive redness over
bony prominences may require the PSRD to be modified. Some
redness or sock marks in the skin are normal in pressure tolerant
areas, i.e. patella tendon or along either side of the tibial
crest. |
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| 1. |
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Your preparatory
prosthesis was made especially for you from a cast impression
of your residual limb. |
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| 2. |
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This prosthesis is designed to
be worn while your residual limb continues to heal and mature
in size and shape. During this time it is expected that adjustments
will be required to maintain the fit and accommodate these
changes. |
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| 3. |
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There are three distinct mechanisms
in the maturing process: |
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a) |
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Post Surgical Edema (swelling):
This is a result of the surgical process.
It is normal and generally resolves in several weeks with
the aid of compressive dressings like ace bandages and stump
shrinker socks. |
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b) |
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Muscle Atrophy (thinning
musculature): The muscles located
in the residual limb generally operate the next joint down.
Muscles in the thigh operate the knee and muscles in the leg
operate the ankle. Because these muscles no longer function
as they normally do, they become smaller from lack of use.
This is normal and advantageous in that as the muscles shrink,
the skeletal parts of the stump have better control of the
prosthetic socket. The majority of these changes generally
occur within the first few months after amputation. |
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c) |
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Long Term Effects of Socket Pressure:
These changes occur over a long period
of time and are the body's natural response to long-term pressure.
This effect is simsilar in nature to those from waist belts
or bra straps. They may occur indefinitely. Remember your
body never stops changing. |
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The prosthetic
socket environment is warm, dark, and humid,. This is ideal
for bacterial growth. |
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It is imperative that the skin
and textiles (socks) be clean and washed daily. Care instructions
are included with packaging. |
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The socket liner (insert) should
also be washed regularly. Soap and water with a sponge or
a soft cloth works well, water will not harm the liner. Soap,
alcohol and detergents like Palmolive or Fantastic are fine
for problem cleaning. Be sure to use plenty of water to rise
and residue. Dry with a towel. |
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The plastic socket should also
be cleaned periodically. |
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Be aware of any changes such as
noises or looseness developing. If this occurs, contact the
office as soon as possible. |
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Never hesitate to contact the office
with any questions or concerns. |
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Stump socks are
the best tool to adjust the fit. |
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As your wear the prosthesis the
stump usually gets smaller. |
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As the stump gets smaller, it stinks
deeper into the socket. |
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As it sinks deeper, more pressure
is felt on the end of the stump or in the calf. |
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Other areas can be problematic
as the stump rests lower than the intended socket contours. |
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As
fitting problems arise, the first thing to try is adding a
stump sock. This will tighten the fit
and raise the stump in the socket back to its intended position. |
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Stump socks may have to be added
during the day to accommodate changes in stump volume. |
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Be careful not to over sock. Too
much sock will keep the stump too high and also cause fitting
problems. Be sure the socket goes on all the way. |
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If stump socks are not effective
in adjusting the fit, call the office for an appointment. |
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Changes are expected and other
means of adjusting the fit are usually needed from time to
time. |
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