Abstract
Objective
To determine the effect of a removable rigid dressing (RRD) on the time to residual
limb maturation compared with elastic bandage (EB) in transtibial amputees.
Design
Experimental single-blinded (assessor-blinded) randomized controlled trial.
Setting
Department of Rehabilitation Medicine, King Chulalongkorn Memorial Hospital.
Participants
Transtibial amputees (N=25) with immature residual limb.
Intervention
Participants were allocated to use RRD or EB to achieve residual limb maturation,
and all participants in both groups were trained with the same preprosthetic program.
Main Outcome Measures
The time to residual limb maturation, patient satisfaction, and complications were
compared between the 2 groups.
Results
Median time to residual limb maturation was significantly lower in the RRD group (median,
28d [interquartile range, 17-51d]) than in the EB group (median, 54d [interquartile
range, 30-77d]; P=.020). After accounting for time since amputation, maturation time remained significantly
lower in the RRD group (adjusted hazard ratio, 3.32; 95% CI, 1.08-10.20; P=.036). There was no significant difference in complications or patient satisfaction.
Conclusion
In postoperative management of transtibial amputation, the use of RRD had a significantly
shorter period to residual limb maturation when compared with the EB group.
Keywords
List of abbreviations:
EB (elastic bandage), RD (rigid dressing), RRD (removable rigid dressing), SD (soft dressing)To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to Archives of Physical Medicine and RehabilitationAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Estimating the prevalence of limb loss in the United States: 2005 to 2050.Arch Phys Med Rehabil. 2008; 89: 422-429
- Effects of early mobilization on unhealed dysvascular transtibial amputation stumps: a clinical trial.Arch Phys Med Rehabil. 2009; 90: 610-617
- Efficacy of removable rigid dressing after transtibial amputation in diabetes mellitus patients.Med J Indones. 2013; 22: 16-21
- Comparison of removable rigid dressing and elastic bandage in reducing the residual limb volume of below knee amputees.J Med Assoc Thai. 2008; 91: 1441-1446
- Comparison of removable rigid dressings and elastic bandages in preprosthetic management of patients with below-knee amputations.Phys Ther. 1982; 62: 1438-1441
- An innovative removable rigid dressing technique for below-the-knee amputation.J Bone Joint Surg Am. 1979; 61: 724-729
- The healing of below-knee amputations: a comparison of soft and plaster dressing.Am J Surg. 1977; 133: 716-718
- The deleterious effect of immediate postoperative prothesis in below-knee amputation for ischemic disease.Surgery. 1974; 76: 992-1001
- Use of removable rigid dressing for transtibial amputees rehabilitation: a Greenwich Hospital experience.Aust J Physiother. 1998; 44: 135-137
- Do rigid dressings reduce the time from amputation to prosthetic fitting? A systematic review and meta-analysis.Ann Vasc Surg. 2014; 28: 1801-1808
- Removable rigid dressings versus soft dressings: a randomized, controlled study with dysvascular, trans-tibial amputees.Prosthet Orthot Int. 2005; 29: 193-200
- Results of managing transtibial amputations with a prefabricated polyethylene rigid removable dressing.J Prosthet Orthot. 2007; 19: 2-4
- A comparison of immediate postoperative rigid and soft dressings for below-knee amputations.Ann Vasc Surg. 2013; 27: 774-780
- Removable rigid dressings: a retrospective case-note audit to determine the validity of post-amputation application.Prosthet Orthot Int. 2008; 32: 223-230
- Early treatment of trans-tibial amputees: retrospective analysis of early fitting and elastic bandaging.Prosthet Orthot Int. 2005; 29: 3-12
- A randomised trial of rigid stump dressing following trans-tibial amputation for peripheral arterial insufficiency.Prosthet Orthot Int. 2004; 28: 22-27
- A simple anthropometric method for calculating segmental leg limb volume.Res Q. 1974; 45: 211-214
- Postoperative management of lower extremity amputations.Phys Med Rehabil Clin N Am. 2006; 17: 173-180
- Removable rigid dressings for postoperative management of transtibial amputations: a review of published evidence.PM R. 2018; 10: 516-523
Article info
Publication history
Published online: May 21, 2020
Footnotes
Supported by Ratchadapisek Sompoch Endowment Fund Chulalongkorn University (grant no. RA61/002).
Clinical Trial Registration No.: TCTR20170928004.
Disclosures: none.
Identification
Copyright
© 2020 by the American Congress of Rehabilitation Medicine
ScienceDirect
Access this article on ScienceDirectLinked Article
- CorrectionArchives of Physical Medicine and RehabilitationVol. 102Issue 8
- PreviewIn the article “Comparison of removable rigid dressing and elastic bandage for residual limb maturation in transtibial amputees: a randomized controlled trial,” published in the October 2020 issue (VOLUME 101, ISSUE 10, P1683-1688, DOI: https://doi.org/10.1016/j.apmr.2020.05.009 , https://www.archives-pmr.org/article/S0003-9993(20)30298-7/fulltext , there were errors in Table 1. Some data were switched between two columns. The corrected table is shown here.
- Full-Text
- Preview
