"AK Retention Device"

"AK Retention Device"

Warren Mays

9/28/2017

Hello Again!

 

We figured this out for ourselves, but thought we would share the responses,
as I had never heard of this item before. We found that (as did several of
the respondents) that Knit-Rite does indeed make a Post-Op Dressing
Retention Sock, which is simply a loose open-ended sock (seems to be made of
the same material as the Soft Sock) with a waist belt attached. Its
purpose, at least in the application that it was requested for, is to help
hold up the Ace Wrap they are using in the post-op setting to help shape the
patients' limb.

 

Thank you to all who responded. All replies are listed below:

 

- First, a proper prosthetic shrinker will in fact pull the stables together
and assist in the healing. You can use the elastic tubular socks and use a
larger size than you would for compression, but no matter what you do, the
ace wrap or prosthetic shrinker will tend to slip distally. I would use a
shrinker with silicone beads at the proximal end to minimize this issue, but
even this does not seem to resolve this problem, even when a waist belt is
attached.

 

- Stitch cotton stockinette to make a simple non elastic sock or if you have
large enough one ply stump socks use that. I never heard of such a thing but
it sounds to me that's all they want. Something to hold the ace bandage in
place. Then follow up when the stitches are out.

 

- Strange. Ace wrap fig of 8 or shrinker, mild, is pretty standard here. I
had no issues with them applied over staples on BKs or AKs. What are they
trying to 'retain? It has to be some sort of elastic application. Hey, a
gel liner? great retention AND protection.

 

- My first thought is telling them that our profession is aware of these
concerns and are best prepared to address them. In short, this is our scope
of practice. I know that I'm preaching to the choir and that you know this
already.

Bottom line, ace wrap is trading concern for possible snagging of the
staples for certain roping of the ace wrap. The answer is to provide a
donning tube for the tubular elastic dressing with suspension attachment
(translation-oversized AK tubigrip shrinker).

Real-world problem.the nursing staff is disinclined to learn about this and
will likely screw it up. Perhaps engage the OT to champion this ADL? I
provided 4 inservices and nurses still turned them into tourniquets.

I put it into terms that they understand. I ask how does this patient get
venous return? The mechanism for return was surgically removed. With
cardiac pressure, arterial muscle pressure and gravity all creating
hyperedema, how do they expect to manage the pain and prevent the incision
site from dehiscence (splitting open---it sounds really impressive, right?)
Research shows that proper vascular care after amputation can reduce healing
time by one month and there's indication that preventing excessive edema
reduces pain. As long as the patient is incapable of movement in bed, they
are appropriate for ace wrap. Unfortunately, they've found that within
repositioning 3 times, ace wrap becomes displaced and progresses towards
limb constriction (I just made that up, but it sounds about right, doesn't
it?).

 

- Stump sock?

 

- Knitrite has AK retention socks with waist belts That are similar to a
trap torso sock Very stretchy

 

- Google netting bandage on amazon.

<URL Redacted>

r_1_2_a_it/141-7186807-3918169?ie=UTF8&qid=1506630830&sr=8-2&keywords=nettin

g+bandage

I've seen stuff like this used before. I'm sure the hospital has some
already, it's pretty common stuff for wounds.

 

- Knit Rite makes it. AK Retention sock, looks like their compression
shrinker with waist belt. No compression. Comes in S-XL sizes I believe.

 

- Knit rite has a post - op no compressive AK sock you can order. We stock
them. Or you can just send over that referral and I'll take care of it ;)

 

 

Thank you to all who responded. I appreciate your thoughts and ideas.

 

Warren R Mays, CPO

 

 

 

 

 

From: Warren Mays [mailto:<Email Address Redacted>]
Sent: Monday, September 25, 2017 11:38 AM
To: List Serve ( <Email Address Redacted> )
Subject: AK Retention Device

 

Hello All,

 

We have received an order for an AK retention device. Apparently, the
purpose of this fabric device is to help hold an ace wrap in place. The
patient has staples over the closure, so they are not wanting a shrinker
sock. They have previously ordered this and gotten some sort of non-elastic
fabric garment. Any thoughts?

 

Thanks,

 

 

Warren R Mays, CPO