responses- shrinker for thunder thigh

responses- shrinker for thunder thigh

Joan Cestaro

12/6/2001

Thanks for the overwhelming number of responses! They are as follows:

We use a lot of Juzo shrinkers but I like Compressogrip and think it
lends
itself especially well to immediate post op and painful residuums if you

apply it over a plastic tube.

The large thighs do represent a problem but maybe I don't bring the
shrinker
up high enough to have that problem. It does occur to me that you could
use a
larger size comressogrip and sew a tapered shape into it. Maybe make a
nice
garter belt to hold it up!

You might recommend the patient get queen size pantyhose and tie a
knot in the end of the affected limb at the distal end of the residual
limb. This helps contain the tissue, and aids in suspending the
shrinker. It doesn't always work, but helps with most. The only other
solution is a garter belt, custon modified with extra clasps.

Juzo shrinkers are vastly superior in both fit and result. For the
extremely fleshy individual fitting a bk with a long ak shrinker with
hip
attachment can prevent rolling but honestly that is rarely necessary as
they do not roll down easily.

Today I fit a 400lb patient with an extra large alpha liner. It did not
roll down and he will wear it like a shrinker for 2 weeks. I usually
recommend less wear time because the liner does not breath like a
shrinker but that is just me.

in situations such as the one you describe I have succesfully used the
Iceross Comfort plus liners as shrinkers.
Advantages: No distal migration, easy donning and doffing, easily
reproduced
by Allied Health professionals, easily washed, can be used as a
definitve
liner, and they do not lose their compression over time.
Disadvantages: cost, cannot be billed as a shrinker and then as a
suction
sleeve ( I bill with the Prosthesis as a L5976 in conjunction with the
lock
mechanism) and the are expensive to replace if lost.
I hope this helps!!

Have you tried Juzo shrinkers,
www.juzousa.com
I believe they can also do custom shrinkers for extreme sizes.

I also use the compressogrip shrinkers and have similar problems. Try
the Juzo shrinker in these cases as it has a more tapered shape.

Try a BK shrinker from Juzo and have them add a silicon border to the
proximal border.

For our thunder thighs we have been doing very well utilizing the
compressogrip shrinkers and 3-4 dabs of IT STAYS around the proximal
edge of the shrinker. I instruct the individual or caregiver to try one
little spot on the front of the thigh initially and check it several
times over the next hour or 2. If there is no allergic rxn (usually is
not), then they usually have no trouble. It has been working well for
us.

I have had some luck taking regular pelite and making a piece to go
circumferentially all the way around the distal thigh, just above the
patella. You can attach with velcro closure if desired. The shrinker
then rolls over this, and for the most part will stay in place and will
not curl up. Trim any extra pelite above proximal aspect of shrinker.

In the case of Thunder Thighs I like to use BK Juzo shrinker with a
silicone top band. It really work quite well.

Joan, attach a strap and waist belt to the shrinker, it's always worked
for me. You can also use a long ak shrinker sometimes but this is kinda
rare she needs to have a short femor with short resid. limb. Just use
the garter straps as an attachment to the shrinker affixed to any type
waist belt you come up with.

I get a bottle of It Stays from Jobst. This is a roll-on skin adhesive
designed to prevent that very problem. You can also get various other
skin adhesives from a medical supply house.

      Knit Rite makes and sells a double taper bk stump shrinker in
medium and hevy weights which accomodates the larger thighs and/or large
differential between the distal and proximal circumferences.

Have you tried IT Stays from Jobst It is a body glue for stockings
Just a thought

I've always used Juzo without problem. I use the 15 length for TT's and
this has always been an appropriate length. I also use the 3512, or
heavy compression. My feeling is the 3511 isn't tight enough to reduce
edema efficiently.

I realize these are more expensive than the compresso-grip variety, but
like so many other things...you get what you pay for!

Julius-Zorn (JUZO) carries a great line of shrinkers BK and AK. They
are
fabulous and come in an 8 length and possibly a 6length.
Hope this helps

One thing that I have done is apply a neoprene knee support called the
Miracle Knee Brace around the prox. thigh first to contain the tissue.
Yes I knw that it's a knee brace, but what the hey. It's a long wrap
around knee sleeve that we use quite a bit in my practice. We have a
ton of thunder thighs in pittsburgh. Then apply the shrinker over the
residual limb and over the knee sleeve. It comes in 2 sizes, standard &
maxi. It is an added expense, but it does make your life as a
practitioner easier;especially if this patient ends up in a nursing home
etc. You can get these from a gentleman by the name of Mark Stevens,
Mesco Medical (973) 584-9664. Good Luck, and have a Merry Christmas.

Hi Joan, I have used in the past for those well endowed individuals Juzo
custom design shrinkers with the possible application of a skin adhesive
called it stays obtainable through Jobst. Hope this helps.

I've been experiencing the same problem and here's been my solution:
Choose the appropriate width of tubigrip or compressogrip: find a size
that fits the thigh well and sew the distal part snugger on a serger.
Invert the shrinker and place it on a cast that measures close to the
proximal thigh size and coat the top 2 inches with a thin layer of
silicone cement. I use Wacker RTV Adhesive Sealant SWS951. It is
non-allergenic and lasts a long time. When you smear it on the cloth,
rub it firmly with isopropyl alcohol and let it dry 3 hours before
applying to the client. You can use the same modification to a reg.
shrinker from a manufacturer like Juzo. They actually have some with a
silicone band attached, but you'll still need to do the custom-sewing.

When we used rigid dressings on pt and had trouble with the stockinette
rolling we used good old fashioned garter belts. try camp or
freeman..also you can used a custom style from knit rite..Martha can
whip up anything...I know that she has semi retired but try them...I
also used a lycra sock/shrinker on a thunder calf to cover a dressing
and provide compression post op recluse spider bite.I took a few
measurements your basic cone shape should work and it wasn't even that
costly if I recall correctly.Good Luck.

Joan K. Cestaro, C.P.
Rehabilitation Practitioners, Inc.
Winchester, Virginia

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