Trans-tibial prosthesization in large area of residual limb wound: Is it possible? A case report

Traballesi, Marco; Averna, T.; Delussu, Anna Sofia; Brunelli, Stefano

doi:10.1080/17483100903038568

Cited by 7 publications

(8 citation statements)

References 16 publications

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“…Vacuum-assisted suspension (VAS) of prosthetic sockets uses electrical or mechanical pumps to create a negative pressure differential, relative to the atmospheric pressure, between the interior of a prosthetic socket and the surface of a liner-clad residual limb. Since VAS was introduced and adopted in the late 1990s, investigations of VAS have focused on lower-limb prosthetic applications and the effects of vacuum on residual-limb volume [2][3][4][5], socket suspension [2], socket fit and interface pressures [6][7], gait kinematics, and residual-limb health [8][9]. These studies suggested VAS improves the limb health of prosthesis users by minimizing traumainducing relative motion between the socket and residual limb, as well as by promoting tissue hydration, evidenced by reduction in fluctuations in residual-limb volume.…”

Section: Introductionmentioning

confidence: 99%

Methods for characterization of mechanical and electrical prosthetic vacuum pumps

Komolafe

Wood²,

Caldwell³

et al. 2013

J Rehabil Res Dev

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Despite increasingly widespread adoption of vacuum-assisted suspension systems in prosthetic clinical practices, there remain gaps in the body of scientific knowledge guiding clinicians' choices of existing products. In this study, we identified important pump-performance metrics and developed techniques to objectively characterize the evacuation performance of prosthetic vacuum pumps. The sensitivity of the proposed techniques was assessed by characterizing the evacuation performance of two electrical (Harmony e-Pulse [Ottobock; Duderstadt, Germany] and LimbLogic VS [Ohio Willow Wood; Mt. Sterling, Ohio]) and three mechanical (Harmony P2, Harmony HD, and Harmony P3 [Ottobock]) prosthetic pumps in bench-top testing. Five fixed volume chambers ranging from 33 cm(3) (2 in.(3)) to 197 cm(3) (12 in.(3)) were used to represent different air volume spaces between a prosthetic socket and a liner-clad residual limb. All measurements were obtained at a vacuum gauge pressure of 57.6 kPa (17 inHg). The proposed techniques demonstrated sensitivity to the different electrical and mechanical pumps and, to a lesser degree, to the different setting adjustments of each pump. The sensitivity was less pronounced for the mechanical pumps, and future improvements for testing of mechanical vacuum pumps were proposed. Overall, this study successfully offers techniques feasible as standards for assessing the evacuation performance of prosthetic vacuum pump devices.

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Section: Introductionmentioning

confidence: 99%

Methods for characterization of mechanical and electrical prosthetic vacuum pumps

Komolafe

Wood²,

Caldwell³

et al. 2013

J Rehabil Res Dev

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“…However, only a few studies have explored this possibility. Traballesi et al 13 published a case report of a 60-year-old male with a transtibial amputation due to type II DM who was able to participate in gait training and ambulate for 4 h a day in a VAS system while a large wound on his residuum healed. Brunelli et al 12 compared 7 persons with transtibial amputation and residual limb wounds managed with VAS prostheses to 17 persons with transtibial amputation without wounds managed with patella tendon bearing (PTB) sockets.…”

Section: Introductionmentioning

confidence: 99%

Using vacuum-assisted suspension to manage residual limb wounds in persons with transtibial amputation

Hoskins

Sutton

Kinor³

et al. 2014

Prosthetics &Amp; Orthotics International

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“…14,15 With 82% of lower-limb loss because of dysvascular complications, 16 it is crucial that devices decrease interface stresses while minimizing gait deviations. [3][4][5]7 It is proposed that vacuum applies mechanical forces to the wound that deform tissues, resulting in deformation of cells, followed by stimulation of growth factor pathways, leading to increased mitosis and production of new tissue. Given the positive effects of vacuum-assisted suspension on tissue health and healing, it may provide a useful tool for preventing further amputation in persons with diabetes, although this requires more research.…”

Section: Discussionmentioning

confidence: 99%

“…Vacuum systems have been reported to reduce pistoning of the transtibial residual limb within the socket and maintain limb volume. 4,5 Reasons for improved limb health are not yet fully understood. 3 In addition, individuals who wear vacuumassisted suspension show an improvement in wound healing.…”

mentioning

confidence: 99%

Use of a Partial Foot Prosthesis With Vacuum-Assisted Suspension: A Case Study

Arndt

Caldwell

Fatone

2011

JPO Journal of Prosthetics and Orthotics

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Vacuum-assisted suspension uses the creation of a negative pressure differential to hold a gel liner securely to the walls of the prosthetic socket to reduce the migration of the residual limb within the prosthesis. The eliminated movement or pistoning of the residual limb within the socket is believed to contribute to increased comfort and function in persons with a transtibial amputation by reducing peak pressures during ambulation. A new socket system was developed with vacuum-assisted suspension for a person with partial foot amputation to take advantage of this better coupling. The purpose of this case study was to evaluate the use of a partial foot prosthesis with vacuum-assisted suspension in a 68-year-old man with a right transfemoral amputation and a left partial foot amputation, both of traumatic origin. A questionnaire was used to compare the subject's satisfaction and function between his previous and new prosthesis. Photographs of the residual limb were taken before initial fitting of the new prosthesis, 10 days after initial fitting, and at 2-month follow-up to document the appearance of the residual limb. The subject rated the prosthesis with vacuum-assisted suspension higher with regards to comfort during standing and walking (i.e., it was more comfortable) and lower for pain while wearing the prosthesis (i.e., it was less painful). Photographs at 2-month follow-up showed that the skin was healthier in overall appearance when compared with initial fitting. This case study suggests that the use of a prosthesis with vacuum-assisted suspension may be a viable design for improving comfort, function, and residual limb health for persons with partial foot amputation. (J Prosthet Orthot. 2011;23:82-88.) KEY INDEXING TERMS: artificial limb, prosthesis, vacuum-assisted suspension, partial foot amputation BRIAN ARNDT

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Trans-tibial prosthesization in large area of residual limb wound: Is it possible? A case report

Cited by 7 publications

References 16 publications

Methods for characterization of mechanical and electrical prosthetic vacuum pumps

Methods for characterization of mechanical and electrical prosthetic vacuum pumps

Using vacuum-assisted suspension to manage residual limb wounds in persons with transtibial amputation

Use of a Partial Foot Prosthesis With Vacuum-Assisted Suspension: A Case Study

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