Responses to Harmony VASS Inquiry
Custom Prosthetic Services Ltd.
Description
Collection
Title:
Responses to Harmony VASS Inquiry
Creator:
Custom Prosthetic Services Ltd.
Date:
10/17/2005
Text:
Original Posting:
(Additional articles and studies received in responses are available upon request)
Dear Members;
I wonder if anyone has information regarding the
advisability of using a Harmony VASS system on a
geriatric trans tibial amputee who also has Diabetes and PVD? This gentleman has a mature and fairly
bony residuum and he has had comfort problems with
the total volume control / ALPHA liner approach. He
is a retired engineer and he will be able to comply
with the VASS protocol.
Thank you in advance,
Geoffrey Hall C.P. ( c )
--------------------------------------------------------------------------------
Responses:
--------------------------------------------------------------------------------
My experience with geriatrics has been that it works well -when they are walking- unfortunately they sit a lot, and when they are sitting the vacuum is slowly lost until the weight of the VASS unit becomes a real problem. In order for the VASS to be a good choice you need an extremely active amputee that is on their feet most of the day.
--------------------------------------------------------------------------------
When in clinical practice I was a big fan of VASS (still am), and had good success with it's use in vascular patients. There are some definite advantages for the vascular group of patients. Lack of pistoning being the obvious, but also volume control has been documented. A particular area that I'm interested in studying is the possibility that because it has been shown that limb volumes remain more constant, are there also some improved peripheral circulation spin-offs? I think there may be an increase in tissue oxygenation. It is becoming more common to use vacuum systems for improving healing rates in wound management - there may be a link??
-----------------------------------------------------------------------------------
I have a few diabetic clients who are wearing elevated vacuum systems. One is also on dialysis. Compliance and awareness of fit is the key. If they cannot manage their limb volume, or know when the socket is fitting
properly, then I would likely not use this approach. In some cases, we provide a clear test socket as their fitting tool. Each day, they apply the clear socket for confirmation that the socket is fitting as it should;
sock up, if needed, and then apply their prosthesis. When in question during the day, they remove the prosthesis and check again. In reality, these folks are likely the ones that should not be using this technology. But, there are borderline cases in everything and trying this approach, I
believe, is helpful. Hope it helps some.
-------------------------------------------------------
I have successfully used the Vass system on a Diabetic PVD patient. He was younger than your patient appears to be. My patient is 45, but had chronic issues with breakdown using the alpha and the ossur systems. Vass also helped him control his volume issues.
-------------------------------------------------------
I have used the VASS Harmony system numerous times on the type of patient you mention with great success. As long as the wearer is compliant with donning procedures, it is an excellent choice of components.
------------------------------------------------------
I THINK IT IS WORTH A TRY BUT ADVISE HIM ON THE FRONT END THAT IT WILL BE A VERY TIGHT FIT. ALSO DO NOT MAKE RELIEFS IN THE SOCKET AS THE VACUUM WILL SUCK A HICKIE ONTO HIS STUMP. INSTEAD OF MAKING A RELIEF TRY PUTTING A PAD ONTO THE MOLD WE YOU WANT THE RELIEF AND PULING THE SOCKET OVER THIS PAD, BUT I WOULD PUT A PVA BAG OVER THE MOLD PRIOR TO MAKING THE SOCKET AS THE EXCESS HEAT FROM THE SOCKET DIRECTLY ONTO THE FOAM PAD WILL SHRINK THE PAD AS WELL AS MAKE THE PAD STIFFER. GOOD LUCK, AND FYI I WOULD USE A PE-LITE
LINER AND SUSPENSION SLEEVE FOR THIS GENTLEMAN.
-------------------------------------------------------------------------------------
End of Responses
(Additional articles and studies received in responses are available upon request)
Dear Members;
I wonder if anyone has information regarding the
advisability of using a Harmony VASS system on a
geriatric trans tibial amputee who also has Diabetes and PVD? This gentleman has a mature and fairly
bony residuum and he has had comfort problems with
the total volume control / ALPHA liner approach. He
is a retired engineer and he will be able to comply
with the VASS protocol.
Thank you in advance,
Geoffrey Hall C.P. ( c )
--------------------------------------------------------------------------------
Responses:
--------------------------------------------------------------------------------
My experience with geriatrics has been that it works well -when they are walking- unfortunately they sit a lot, and when they are sitting the vacuum is slowly lost until the weight of the VASS unit becomes a real problem. In order for the VASS to be a good choice you need an extremely active amputee that is on their feet most of the day.
--------------------------------------------------------------------------------
When in clinical practice I was a big fan of VASS (still am), and had good success with it's use in vascular patients. There are some definite advantages for the vascular group of patients. Lack of pistoning being the obvious, but also volume control has been documented. A particular area that I'm interested in studying is the possibility that because it has been shown that limb volumes remain more constant, are there also some improved peripheral circulation spin-offs? I think there may be an increase in tissue oxygenation. It is becoming more common to use vacuum systems for improving healing rates in wound management - there may be a link??
-----------------------------------------------------------------------------------
I have a few diabetic clients who are wearing elevated vacuum systems. One is also on dialysis. Compliance and awareness of fit is the key. If they cannot manage their limb volume, or know when the socket is fitting
properly, then I would likely not use this approach. In some cases, we provide a clear test socket as their fitting tool. Each day, they apply the clear socket for confirmation that the socket is fitting as it should;
sock up, if needed, and then apply their prosthesis. When in question during the day, they remove the prosthesis and check again. In reality, these folks are likely the ones that should not be using this technology. But, there are borderline cases in everything and trying this approach, I
believe, is helpful. Hope it helps some.
-------------------------------------------------------
I have successfully used the Vass system on a Diabetic PVD patient. He was younger than your patient appears to be. My patient is 45, but had chronic issues with breakdown using the alpha and the ossur systems. Vass also helped him control his volume issues.
-------------------------------------------------------
I have used the VASS Harmony system numerous times on the type of patient you mention with great success. As long as the wearer is compliant with donning procedures, it is an excellent choice of components.
------------------------------------------------------
I THINK IT IS WORTH A TRY BUT ADVISE HIM ON THE FRONT END THAT IT WILL BE A VERY TIGHT FIT. ALSO DO NOT MAKE RELIEFS IN THE SOCKET AS THE VACUUM WILL SUCK A HICKIE ONTO HIS STUMP. INSTEAD OF MAKING A RELIEF TRY PUTTING A PAD ONTO THE MOLD WE YOU WANT THE RELIEF AND PULING THE SOCKET OVER THIS PAD, BUT I WOULD PUT A PVA BAG OVER THE MOLD PRIOR TO MAKING THE SOCKET AS THE EXCESS HEAT FROM THE SOCKET DIRECTLY ONTO THE FOAM PAD WILL SHRINK THE PAD AS WELL AS MAKE THE PAD STIFFER. GOOD LUCK, AND FYI I WOULD USE A PE-LITE
LINER AND SUSPENSION SLEEVE FOR THIS GENTLEMAN.
-------------------------------------------------------------------------------------
End of Responses
Citation
Custom Prosthetic Services Ltd., “Responses to Harmony VASS Inquiry,” Digital Resource Foundation for Orthotics and Prosthetics, accessed November 5, 2024, https://library.drfop.org/items/show/225628.
