Early post-operative mobilisation is very important. It assists with wound healing (as the pumping action improves circulation while walking), your general wellbeing and gets you up and going in society and in life in general.
It is very important that you know exactly what the process of rehabilitation involves after you have received an amputation. You should join a team consisting of at least a Surgeon, Prosthetist and Physiotherapist. Other members can be your wound care sister as well as a Psychologist.
The days of walking only months after receiving an amputation are long gone. At our practice, we are a part of a team that knows the importance of an amputation done the correct way, quick mobilisation and proper gait training
The success of prosthetic rehabilitation starts on the theatre table. The Surgeon must know and understand what happens after a prosthetic amputation. Therefore the surgeon must know which componentry is going to be used, the height of the componentry, the type of suspension that is going to be used, the length of the residual limb etc……
In our team, I accompany the Surgeon in the theatre to ensure that he is aware of the specifics of the shape and length of the prosthetic limb and what needs to be done in surgery. Stump shaping directly after the amputation is very important. Excessive swelling is bad for wound healing; therefore, we fit a rigid dressing on the residual limb directly after the surgery. This begins the “coning”, healing process and protection of the residual limb and prevents knee contractures. This dressing is kept on for 8 days, 24 hours a day, and can be easily removed for wound inspection and cleaning.
After this period we fit “post-operation silicone liners” which are measured and fitted to size. The specific measured liner is rolled onto the residual stump and gives further compression. The liners improve blood circulation, protect the residual limb, prevent swelling and shape the residual limb. You, as the user, need to learn how to don and doff the silicone liner, as this is going to be a part of your continuous prosthetic set up. The liner is worn for a 2 – 3 week period, where you visit our practice once a week to take measurements and to receive a smaller size liner as your residual limb starts to shrink.
3 – 4 weeks after amputation, we start fitting you with a temporary interim prosthesis which is made in 2 hours. As further quick volume reduction occurs when you start walking, the prosthesis will only fit your residual limb for 6- 12 weeks.
After this period of wearing your interim prosthesis, the final prosthesis is manufactured and you can continue improving your mobilisation.
You can download the immediate post-operative manual for more detailed information and pictures.