Post-operative care focuses on limb management and continued patient assessment. A clinical consultation is normally followed by the introduction of compression therapy, including commonly used textile shrinkers intended to manage edema and promote residual limb shaping. Additionally, there are traditional and non-traditional rigid dressings and complete prosthetic systems that can allow weight bearing therapies to be introduced.

Once the sutures or staples have come out, and the surgical wound has healed you can begin to prepare for your initial prosthesis. The following steps below are a guide working towards getting you ready for this to occur.

Post-operative care focuses on limb management and continued patient assessment. A clinical consultation is normally followed by the introduction of compression therapy, including commonly used textile shrinkers intended to manage edema and promote residual limb shaping. Additionally, there are traditional and non-traditional rigid dressings and complete prosthetic systems that can allow weight bearing therapies to be introduced.

Once the sutures or staples have come out, and the surgical wound has healed you can begin to prepare for your initial prosthesis. The following steps below are a guide working towards getting you ready for this to occur.

Following a lower or upper extremity amputation one of the initial steps on the road to recovery is compression therapy. Almost all surgical procedures will result in some form of swelling (edema) to the soft tissues which is a body’s natural protective response. This reaction is especially common following an amputation which is why compression therapy using a shrinker sock plays an important role. Before a prosthetic socket can be designed the limb must be shaped and swelling needs to be reduced and controlled.

While an elastic “Ace wrap” bandage is sometimes initially used, their application can be difficult to consistently apply. A cloth shrinker, when pulled over the residual limb, provides a more consistent even compression gradient which will help to control swelling and promote shaping of the soft tissues especially at the end of the limb. Shrinkers are normally worn once the majority of the suture line is healed and most if not all of the staples and/or stitches have been removed. The shrinker sock should be worn at all times except when bathing. Throughout the day you will need to keep it pulled up to maintain a snug fit at all times. It is common in time to need a smaller size shrinker as your limb changes, so communication with your prosthetist is key.

Once provided your initial prosthesis, limb volume reduction will continue. Most people experience the majority of limb shrinkage during the first year following surgery with gradual shrinkage (atrophy) occurring over time.

These are occasionally used for those considered a high fall risk and are generally made of a semi rigid plastic materials. They are applied over the limb to provide protection from impact during walking activities. RRD’s are often used in conjunction with a shrinker sock and help maintain the knee in extension to prevent contracture development to maintain full range of motion.

Make sure to contact your prosthetist at 757-595-9800 if you have questions regarding wear.

Rehabilitation Options :

• Home Health Therapy

• Skilled Nursing Facility

• Out Patient Therapy

• Functional Assessment

Prior to or in conjunction with prosthetic provision, rehabilitation can be offered in a number of settings to help the patent prepare physically and emotionally for prosthetic use. These services can be provided in acute rehabilitation hospitals, skilled nursing facilities or by home health therapists. While home therapy is an initial choice for many, more intensive rehabilitation can be provided at outpatient or inpatient facilities. A key part of the rehabilitation process includes a functional assessment of the patient’s strengths, limitations and goals to better define their plan of care.

Make sure to contact your prosthetist at 757-595-9800 if you have questions regarding post-operative rehabilitation.

Keeping your residual limb in the right position is vital. This helps prevent muscle shortening and tightening (contracture), which can prevent full range of motion. To avoid developing a contracture, you’ll need to keep your knee positioned as straight as possible when seated or lying down.

When seated, always support your residual limb to keep it from dangling or hanging. When sitting in a wheelchair or a regular chair, you can use an “extension board” which is a flat board that extends outward to support your residual limb. When lying down it is important to avoid propping your residual limb on pillows or blankets. Keep your residual limb flat, with your knee or hip as straight as you can as much as possible.

If your amputation is an above the knee, spending time lying flat on your stomach is helpful to stretch the hip and thigh muscles. These muscles get tight when you sit through out the day. It’s important to spend 15 to 20 minutes in this position several times a day to help maintain normal range of motion.

Following surgery the skin on your residual limb can be sensitive to touch. Desensitization through self-massage, rubbing, and/or tapping the end of your residual limb can help control this.

Begin with a light, gentle touch kneeing the skin and increase the pressure as your tolerance allows. Applying cocoa butter during massage hydrates and helps improve the health of your skin especially along the suture line.

Many individuals who have undergone an amputation experience some degree of phantom limb sensation or phantom limb pain. It is thought to occur due to the interruption of signals sent from the brain through the nerves that were extending into the now missing leg or arm.

The sensations are often described as feeling all or part of the missing extremity, whether it be an itch on the toes and foot or in more severe cases the feeling of the extremity being in a cramped position or a burning sensation. There some reports of a correlation in the intensity of phantom limb syndrome considering how much preoperative pain someone experienced versus the cause of the amputation. There are a number of therapies to treat phantom limb ranging from massage techniques to “mirror therapy”. If you experience significant symptoms contact your physician to see what treatments are recommended.

Caring for your residual limb is not very different than caring for the rest of your body, with a few exceptions. Commonly roll-on gel liners are used as a means of suspending the prosthesis and protecting the limb while weight bearing.

Washing your residual limb, using a wash cloth, warm water and a mild antibacterial soap, is recommended at least once a day. You want to avoid the use of soaps with deodorant properties, heavy scents or other additives. Soaps containing these items often leave a residual residue in the pores of the skin. In the case of using a roll-on liner, these properties cannot emit and remain in the pores, which can cause a rash-like skin reaction. If not properly treated it can result in an inability to use their prosthesis until the skin clears. If you need to apply any creams or moisturizers to the skin, do so at night to ensure proper absorption before resuming prosthetic use. When in doubt contact your prosthetist.

As your limb is healing you need to keep the muscles in your residual limb strong and flexible. Doing any exercises you were taught in the hospital is an important part of preparing for prosthetic use and will help prevent contracture development. The stronger one is prior to getting their prosthesis the easier time can be had when it comes to relearning the mechanics of walking.

There is no doubt that amputation changes your life. Gaining knowledge goes a long way in helping you move forward both emotionally and physically.

In addition to the care instructions you get from your rehab team, these simple tips can help make your life easier from the beginnings of life with amputation, to settling into your new normal.

Here are a few tips to make your home safer and more comfortable when you get home from the hospital.

General Tips:

• Have a set of crutches on-hand and practice using them before you get home.

• Set up a comfortable place in your home where you can rest as you recover. Include an area within arm’s reach to store all of the things you regularly use.

• Ensure furniture placements allow clear paths and plenty of room to navigate.

• Assemble a wardrobe with clothing that is easy to get on and off.

• Pockets, shoulder bags and fanny packs are a great method for carrying items without using your hands.

• A rolling stool, chair or wheelchair can help you get around. It’s a good idea to have a stool near your bed to help you get to the bathroom at night.

• Nightlights (and motion detected nightlights) make it easier to navigate when looking for light switches in the dark.

• Remote anything you can. There are all kinds of systems to turn on things like, fans, music, and lights. Amazon and Google make voice activated devices that give you general information and more.

Bathroom Tips:

• Install grab bars in your shower and next to your toilet.

• Get a shower bench for use in your shower.

• Place a non-slip bath mat in front of the shower to help prevent slipping as you are getting in and out.

• Install hooks next to your shower to help keep towels in reach of your bath seat.

• Use a shower head with a hand-held wand to move the water source instead of your body.

• Organize the items you use every day and place them within reach.

• Consider a handicap height toilet – this is a good long-term investment.

Most of all have support in place. Healing takes time and having practical help and supportive people around you will make the adjustment easier. Many have successfully gone before you in this journey. You can do it!