Post Operative Q&A
Delta Orthopedic Laboratory answers some of the most frequently asked questions regarding prosthetic care during the recovery and rehabilitation process after an amputation.
Q: WHAT IS A RIGID DRESSING?
A: The rigid dressing is a sterile dressing combined with a plaster cast. Your doctor may prescribe a rigid dressing which is applied, usually by your prosthetics, to the residual limb immediately after surgery. A tube or pylon and an artificial foot or hand may be attached to the cast so you can begin using the residual limb soon after surgery. Dressing changes usually occur at two-week intervals.
Q: WHY IS THERE SO MUCH SWELLING?
A: Swelling is a natural reaction to the trauma of surgery and will continue throughout the healing process. There is also a tendency for fluids to build up as a result of less muscle activity in the amputated limb.
Q: HOW DO I REDUCE THE SWELLING?
A: Wrapping with elastic bandages or using elastic “shrinkers” decreases the swelling and helps shape the residual limb. It is important that you keep your residual limb properly wrapped or within the shrinker at all times. The swelling will continue to decrease over the next several months as your residual limb shrinks significantly from both fluid loss and muscle inactivity.
Q: HOW SHOULD I TAKE CARE OF MY RESIDUAL LIMB AFTER SURGERY?
A: After the first dressing is changed, an elastic bandage should be used to wrap the residual limb. This bandage should be removed and rewrapped several times each day so it will continue to provide adequate support as your limb shrinks.
Q: WHAT IS PHANTOM PAIN?
A: Many people experience the sensation that the amputated limb is still present. You may have the sensation of tingling, itching, or movement, as well as fleeting episodes of sharp, squeezing, or burning pain. The causes of phantom sensation are not clearly understood, but the experience usually disappears within a few months after surgery. Inform your doctor and prosthetist of any discomfort that you may experience.
Q: HOW SOON AFTER SURGERY WILL I GET MY PROSTHESIS?
A: Many factors determine when you are ready for your first prosthesis. Your residual limb must be well-healed with no tenderness and minimal swelling. Generally, if there are no complications, the first fitting occurs approximately four to five weeks after amputation. If you have poor circulation, the fitting may be delayed an additional two to three weeks to allow for adequate healing.
Q: HOW SHOULD I CLEAN MY RESIDUAL LIMB?
A: Wash your residual limb daily with soap and water. Avoid lotions, oils, or creams because they tend to soften the skin and make it more susceptible to skin breakdown. Always check your residual limb thoroughly for any scrapes, cuts, sores, or reddened areas.
Q: HOW DO I PREPARE MY BODY FOR WEARING MY PROSTHESIS?
A: Exercise is important in increasing your overall strength and flexibility and preparing your muscles for the prosthesis. A physical or occupational therapist assesses your overall physical condition and may prescribe an exercise program. Isometric exercise, which involves tightening and relaxing the muscles, helps you maintain good muscle tone and can be started while you are still in bed. Along with exercise, gradually desensitizing your residual limb is an important step in preparing for your prosthesis. Begin by massaging your limb, then work up to patting it, rubbing it with a towel, and even lightly slapping your residual limb. Preventing contractures (the tightening of the muscles and joints) also makes wearing your prosthesis easier.
Q: WHAT PROSTHESIS IS BEST FOR ME?
A: Your prosthetist consults with your physician regarding the prescription for a prosthesis. There are many individual factors to consider in prescribing the right prosthesis for you. Some of these include the shape and condition of your residual limb, overall medical and physical condition, previous activity level and lifestyle, commitment, and financial situation. Discuss your interests, lifestyle, work and goals with your prosthetist, so he or she can design a prosthesis that provides the highest level of function and independence possible.
Q: HOW IS MY PROSTHESIS MADE?
A: Your prosthesis is made up of many different components selected specifically for you and your lifestyle. Your prosthetist begins by taking a series of measurements and a cast of your residual limb. From the cast, a mold is made and used to design a custom socket. Your residual limb fits snugly in the socket which is attached to the other components that make up your prosthesis. There are also a variety of skin-like coverings that can be used to resemble your other limb as closely as possible.
Q: HOW DO I LEARN TO USE MY PROSTHESIS?
A: During the initial fittings, your prosthetist guides you through the basic principles of using your prosthesis, fine-tuning the fit and alignment as needed. For lower limb amputees, more extensive training (walking on different terrains, climbing stairs, getting in and out of a car) is provided by a physical therapist. If you have upper limb prosthesis, an occupational therapist helps you perform daily living activities such as grooming, eating and handling various objects.
Q: HOW MUCH WILL MY PROSTHESIS COST?
A: Your prosthesis is custom-designed to meet your specific needs using advanced and expensive materials and components. Insurance coverage varies widely, but most private insurance plans and Medicare pays large portion of the charges. Medi-Cal covers certain types of prosthetic devices. Many HMO and PPO plans do not cover prosthetic devices unless you have the higher option plans that include orthotic and prosthetic devices.You will probably have many questions before and after your amputation. We encourage you to talk to your physician, therapist, and prosthetist, and discuss your concerns and receive answers to your questions.
Q: HOW LONG WILL MY FIRST PROSTHESIS LAST?
A: Your first prosthesis is usually worn for about three to six months. During this time, your residual limb continues to shrink and becomes less sensitive. Your prosthetist also makes many adjustments, and prosthetic socks may be added to help the socket fit properly as your limb shrinks. You learn to walk and balance on your new prosthesis, which helps shrink the residual limb faster. If you’ve lost an arm, your first prosthesis allows you to pick up objects and regain daily living skills.
Q: WHEN WILL I BE READY FOR MY DEFINITIVE PROSTHESIS?
A: As soon as your residual limb is healed and the size and shape have stabilized, you are ready for a more complex “definitive” prosthesis. Your definitive prosthesis can last for many years especially if you take proper care of it and have it periodically “checked and serviced” by your prosthetist. Also, it is very important that you maintain your weight. Even a ten-pound weight gain or loss could affect the prosthetic fitting, which requires adjustments or a new prosthesis.