V5 valve alternatives, responses part 2

V5 valve alternatives, responses part 2

Walter P Afable

4/18/2007

Sam again,
Elevated vacuum may need to seal socket due to small leak through
reasin, use 1/8'' petg or equal, blister form over mold, rough
plastic, clean with alchol ( do not use acetone), Lam directly to
plastic, no need for inner PVA, this will create a vacuum seal of the
socket laminate. Alternative Vacuum is a Hand pump to generate vacuum
( Velocity -Labs.com) 321-377-2409, Hand pump either mechanical or
electric, both fit in a womens hand bag.As long as you do not break
seal, vacuum last 4-8 hrs.
SAm Brouillette, CP

[Again, maybe my demise here--will know more tomorrow afternoon.
Thanks Sam.]

*****

Coyote Design has a new expulsion valve that works great, retro due
to it requires a 1/2 hole, no threading reguired just need some good
5min epoxy. This valve is low profile,`1/4'' profile, is servicable,
and sits on the socket anywhere you need, it is also made to take a
hit without snapping in two, Only thing does not currently work with
seal-in liner as there is no release button. Works great for sleeve
suction. Coyote 800-819-5980. I have fit alot of vaccum and suction
had to keep extra V4 and V5's around due to sticking open or
breaking, but most leak problems we experinced that you discribed
were sleeve/seal related.
Hope this helps,call if you need to
Sam Brouillette, CP
980-622-8266

*****

I did not see the article, but an auto parts store mity-vac vacuum
pump will work well. Make sure you have a filter (piece of nylon or
cotton, or something) between the limb and valve to keep dirt out of
the valve. Carl Caspers recommends (at least at one time) clearing
the valve occasionally with alcohol or water. You can do this by
using the vacuum pump after water or alcohol has been poured into the
socket. To test for leaks, put a large balloon over the proximal end
of the socket and pull it down with an electric vacuum pump. Let it
set over night and see what happens. I've held vacuum for several
days when testing. Hope it helps.

Wil Haines, CPO/L

[I should have done this to check the lamination for leak-through.
Thanks Wil.]

*****

The hand pump shown in the warren flip video is a brake bleeder hand
pump used in cars called the mityvac. You should be able to get it
from a big parts house, McMaster and Carr or Grainger. There are
several versions of the hand pump from MityVac the one I like the
best is model #MV6203.

I believe the system you have put together is very appropriate. I
have used the Contex gel sleeve with the Otto Bock custom urethane
liners and had no problems with maintaining vacuum seal on about 6
patients. The Contex sleeve is a good alternative to the harmony and
Vass sleeves. I have found the Contex sleeve to be more durable and
consistent.

I have hooked a tester up to the v5 1 way valve kit and was unable to
get over 3-5 Hg without a hand pump. Every time I gave the patient
a mityvac handpump they could tell an immediate difference. The
vacuum should hold for 2-3 hours before requiring re-pumping. This
depends on the amount of sitting the patient is doing. The pt. needs
to remember that vacuum is an active system ,walking 50% of the day,
and not designed for sitting as vacuum while sitting for extended
periods will become painfull. Remember to apply a little lotion to
the proximal portion of the outside of the Urethane liner to help
bond to the Contex sleeve, sometime this makes the difference between
30 minutes of maintained vacuum and 3 hours of maintained vacuum.


Aaron Fitzsimmons, CP, OTR

[Aaron, I was happy to hear that someone else out there thought my
design was appropriate. I was beginning to let doubt creep in.
Thanks for your input.]

*****

Hi,
Try this link: <URL Redacted>
AQCVK.asp?L+scstore+rvhp5508ff6c216c+1175666737
This is a Canadian Mail Order Pet Supply store. I'm sure you can find
a source south of the 49th. I use the TETRA check valve which is
basically the same as what TEC first used. These valves have a rubber
duck bill valve component. Instead of the fancy TYGON tubing (which
stretches out at the barb connection unless you use the black
connecting rings) I use the appropriate diameter windshield washer
fluid hose from the local auto parts store. I have also found that
the hose can be wedged and shoe-goo's straight into the rubber duck-
bill valve. This seems to work well for those people who don't wear a
cosmetic cover, break the valve constantly or just want a lower
profile valve setup.
Looking forward to your other replies.
Markus Saufferer, C.P.(c)

*****

HAve you considered the BK auto expulsion valves from ESP? They are
medium sized, lightweight, and work by drilling a hole into the
socket, tapping that hole and then scewing in the valve. I believe
Ossur carries them for their BK seal in liner systems. You can also
contact ESP directly or possibly use SPS.
I have used these valves extensively with little problem other than
the occasional failure when the patient knock the inner workings out
and loses the spring or diaphragm. I have learned to always keep
spare parts and give the patient a spare diaphragm and spring (can be
ordered seperately).
James Little, B.Sc., C.P.(C)
Custom Prosthetic Services Ltd.
Victoria BC Canada

*****

I have completed a stovepipe symes using a OWW liner and Alps 6mm
Viva sleeve system with the valve. I did make a wedge that would stay
in place with a nylon over them, but I could not get him into the
test socket with the wedge and left it out. He did not complain of
the fit or of movement within the socket while walking around the
lab. If you read the latest O&P News the guys in FLA have made a
Prosthosos AFO/Symes. The sealing system with the Viva sleeve worked
well with Transtibials so I thought that this could be used with a
closed symes. I should note that this is the second symes that I have
made this way, the first one was a large man with out much contours
around the end of the limb. I cut in slightly for minor compression
over the malleoli on this pt and used the Alps liner and Alps Viva
sleeve, and have yet to hear from him. I hope this helps.



                              Chuck Lopez BOCP, LP

[Patient has tried similar designs in the past, each with only
limited success. Thanks for your suggestions.]

*****

Sounds like an interesting prosthesis you are working on.

One thing I would recommend checking if you haven’t would be the
barbed fitting connection into the socket. If you are using a lot of
carbon in your lamination you may have an air leak along the carbon
fibers. One way to eliminate this is to drill an over sized hole
through the lamination, put a piece of tape over the hole on the
inside and back fill this with lamination resin. Then drill and tape
for the barbed fitting and re-epoxy the barbed fitting. Carbon does
not absorb resin like other materials so the air trapped around the
carbon will often allow air to get into the socket and a drop in vacuum.

Feel free to contact me directly for further discussion about this case.

Kind regards,

Byron Backus, CP

Clinical Specialist, Prosthetics

Otto Bock HealthCare

Phone: 800-328-4058x5664

Mobile: 612-747-7988

*****

[Thanks to everyone for their insights. I followed Byron's
suggestions and drilled the channel out to a 3/8 diameter and filled
it with 5 minute epoxy. I then drilled through the epoxy channel
with a 7/32 drill bit and attached the elbow barb fitting with a
small amount of epoxy on the threads. I connected a pressure gauge
and a V5 valve in series to the elbow. Then I attached the Mity Vac
brake bleeder hand pump, (from the patient's garage of all places) to
the end of the V5 valve. I tested the system by putting my finger
over the hole inside of the socket and was able to draw air out of
the system, disconnect the pump and maintain elevated vacuum with
zero losses--big improvement as this test was failing just days
earlier. I suspect that air was leaking through fibers in the
laminate through the channel down through the bottom of the three
pronged socket adapter. Using epoxy to create a sealed channel fixes
this issue.

Patient scheduled back in tomorrow. We will then be able to re-test
the proximal seal and test the socket material for any losses. With
no holes in the sleeve the system should work as intended.

Thanks again for all of your help. You'll each get checks in the mail.

Walter P Afable, CP]