Responses: "Protective" Jacket

Responses: "Protective" Jacket

Thanks to all who responded, your suggestions are helpful. Below is our
original post followed by the responses.

We recently had a request to fit some type of protective vest or jacket for
an elderly lady with severe scoliosis. She is ambulatory and has to get up
several times during the night. Her problem is that she is getting a pressure
sore on a high right posterior rib hump during her sleep. Positioning and
efforts to change sleeping habits have not prevented recurrence of the
problem. There has been a recent surgical procedure to close the wound and
actually rasp down the sharpness of the ribs. We have been asked to fabricate
something that can be comfortably worn while sleeping that will protect or
relieve pressure on the sight. I'm thinking a soft vest perhaps with a
sheepskin lining. If anyone on the LISTSERV has experience with this type of
situation suggestions would be appreciated.

Thank you in advance,
Eddie White, CP
Beacon Prosthetics and Orthotics
Raleigh NC 27610

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Spinal Technology and Boston Brace offer designs with a foam liner and a
rigid frame to accommodate bony prominences that may offer a solution for
you.
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I would suggest a Spinal Technology flexfoam TLSO. Custom mold and draw the
frame you want on the cast. Keep a
little space on the hump, anterior and lateral area small. You want just
enough frame to protect the area and the
foam padding for comfort. They do good work, but on special designs like this
it is good to be specific.
************
try using webbing in the effected area. or perhaps
accommadate for the pressure are. boston brace has
the webbing material they use on their braces.

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Have you ever seen the TLSO that Boston brace makes for myelomeningicele? It
has a protective cup that fits over the area that you wish to relieve the
pressure. It is removable, so you patient could take it off during the day,
but attach it for protection from bed pressures during sleep.

************
We have made front opening TLSOs using two layers of 1/4 inch aliplast
with a PE frame sandwiched between for stiffness where needed.
We have also fit several TLSOs made from orthoplast lined with 3/16
aliplast. Both have resulted in good compliance by the wearers.
************
I have done something like this, perhaps the area in question was smaller. It
was simply a custom 1/8 polyethylene jacket w/ a 1/4 closed foam soft liner
with a rather generous plaster buildup on the problem area. The build up was
fashioned to allow weight bearing w/o collapsing. The person was cast w/
their bandages in place, and saran wrap over the wound.
***********
Have you used the flexfoam jacket from Spinal Tech? I have used it for
patients with Bone cancer that has metastasized to the spine. You know how
much pain they are in. You can modify the kydex spines within it or the
exterior kydex trimlines to avoid pressure areas. They are so great at
helping you solve problems. If I can be of further help, let me know.