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Residual Limb and Prosthesis Care

Patient care immediately after limb amputation to include monitoring of drainage from the residual limb, positioning of the affected limb, assisting with exercises prescribed by a physical therapist, and wrapping and conditioning the limb.

Postoperative care slightly variable, depending on the amputation site and whether an elastic bandage or plaster cast is used. After the residual limb heals, only routine daily care (proper hygiene and continued muscle-strengthening exercises) needed. Prosthesis to be cleaned and lubricated daily and checked for proper fit.

For Postoperative Residual Limb Care
  • Pressure dressings
  • Abdominal pad
  • Suction equipment, if ordered
  • Over head trapeze
  • 1" adhesive tape
  • Bandage clips or safety pins
  • Sandbags or trochanter roll (for a leg)
  • Elastic limb shrinker or 4" elastic bandage
  • Tourniquet (optional as last resort to control bleeding)
For Residual Limb and Prosthesis Care
  • Mild soap or alcohol pads
  • Special limb socks or athletic tube socks
  • Two washcloths
  • Two towels
  • Appropriate lubricating oil
Essential Steps
  1. Perform routine postoperative care
  2. Provide for the patient's comfort, pain management, and safety.
Monitoring Residual Limb Drainage
  • Gravity causes fluid to accumulate at the residual limb. Frequently check the amount of blood and drainage on the dressing.
  • Notify the physician if accumulations of drainage or blood increase rapidly or excessive bleeding occurs.
  • Apply a pressure dressing or compress to the appropriate pressure points.
  • Keep tourniquet available and use it as a last resort.
  • Tape the abdominal pad over the moist part of the dressing to provide a dry area to help prevent bacterial infection.
  • Monitor the suction drainage equipment and note the amount and type of drainage.
Positioning the Extremity.
  • Elevate the extremity for the first 24 hours
  • To prevent contractures, position the arm with the elbow extended and the shoulder abducted.
  • To correctly position the leg, elevate the foot of the bed slightly and place sandbags or a trochanter roll against the hip to prevent external rotation.
  • After below the knee amputation, maintain knee extension to prevent hamstring muscle contracture.
  • After a leg amputation, place the patient on a firm surface in the prone position for at least 2 hours per day, with his legs close together and without pillows under his stomach, hips, knees, or residual limb, unless this position is contraindicated.
Note: Don't place a pillow under the thigh to flex the hip because this can cause hip flexion contracture. For the same reason, tell the patient to avoid prolonged sitting.

Caring for the Plastic Prosthesis
  1. Wipe the plastic socket of the prosthesis with a damp cloth and mild soap or alcohol to prevent bacterial accumulation.
  2. Wipe the insert, if the prosthesis has one, with a dry cloth and dry the prosthesis thoroughly. When possible, allow it to dry overnight.
  3. Maintain and lubricate the prosthesis and check for malfunctions.
  4. Frequently check the condition of a shoe on a foot prosthesis and change it as necessary.
Applying the prosthesis
  1. Apply the residual limb sock, keeping the seams away from bony prominences.
  2. If the prosthesis has an insert, remove it from the socket, place it over the residual limb, and insert the residual limb into the prosthesis.
  3. If it has no insert, slide the prosthesis over the residual limb.
  4. Secure the prosthesis onto the residual limb according to the manufacturer's direction
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