Responses to Managing Volume Fluctuations

Responses to Managing Volume Fluctuations

Jarrod Eccles

1/10/2013

Dear List,

 

I have received a few responses to my post and will post any more I receive.
The one thing I can't seem to find is info regarding any possible advantages
/ disadvantages to allowing the sweat glands to shut down.

 

Here they are:

1. Usually the texture of compression garments are rough and sand
paper-like. I do not like them Jarred my man, I do not like them worth a
damn. I do not like them under a liner, I do not like them because
uncompromised skin is finer.

 

(I hope you noticed the Green Eggs and Ham flow.) The liner will scratch at
the skin, and almost create a type of rug burn. BUT not with everyone.

 

2. Jarrod,
I would be concerned about peripheral vascular disease patients (eg
Diabetes). The compression garment may work well globally, but the pressure
on the periperal venuoles and arterioles may create an unwanted problem. I
am not saying this will always contraindicate use of compression garments
for specific cases, but i would discuss it with their reffering physician
before you potentially put your patient at risk.
Shrinkers (compression garments) used around the time of decice fitting
(socket or afo) should deal, and stabilize, the volume; to enable the
patients device to manage it while wearing it. In the case of AFOs, if the
patients volume is a problem, concider a conventional AFO to allow the
volume to occur. If the volume is getting in the way of device wear, I would
focus on that issue before the device issue.
Just my private/personal 2 cents worth. These opinions do not represent any
organization or company, just my personal feeling on this topic.

 

3. I would not put a Prosthetic sheath or any compression material
under the liner.

The correct measurement of the liner should do all the compression on its
own. When the pt. is not in his/her liner, I would put on a shrinker until
the volume stabilizes.

The addition of 2 3 5 ply socks will be outside the liner. The only thing
between the liner and the skin is what Marilyn Monroe wore to bed; nothing.
The potential shear; or weft of the compression garment against the fragile
skin is problematic.

I would use the shrinker for the first couple of weeks until the suture line
is cleared up; then order the liner and have them wear the liner for days
to make sure there is no reaction to the material. Then make the check/temp
socket which would keep compressive forces on the limb and deal with the
oedema.

As they wear the socket more, volume reduces and you add the 2 3 5 ply
outside the liner.

So, I would not encourage any material, compression or otherwise under the
liner.