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Stump management after trans-tibial amputation: a systematic review.
S E Nawijn1, H van der Linde, C H Emmelot
1Department of Rehabilitation Medicine, Isala Klinieken, Zwolle, The Netherlands. s.nawijn@introweb.nl
Prosthetics and Orthotics International
|September 27, 2005
Summary
Rigid and semi-rigid dressings show promise for stump healing and volume reduction after trans-tibial amputation. However, more research is needed to establish evidence-based guidelines for optimal post-amputation management.
Area of Science:
- Rehabilitation Medicine
- Orthopedics
- Prosthetics and Orthotics
Background:
- Effective stump healing is crucial for successful prosthetic fitting after trans-tibial amputation.
- Various management techniques exist, including soft dressings, elastic wrapping, rigid/semi-rigid dressings, and silicone/gel liners.
Purpose of the Study:
- To systematically review the literature and identify optimal post-amputation management strategies for stump healing.
- To evaluate the methodological quality of existing controlled studies on transtibial amputation stump management.
Main Methods:
- A systematic literature search was conducted to identify relevant controlled studies.
- Methodological quality was assessed using predefined criteria, classifying studies into A, B, and C levels.
- Eleven controlled studies were evaluated.
Main Results:
- No A-level studies were found; three were B-level and eight were C-level.
- Literature is heterogeneous regarding patient selection, interventions, and outcome measures.
- A trend favors rigid and semi-rigid dressings for stump healing and volume reduction.
Conclusions:
- Rigid and semi-rigid dressings appear beneficial for stump healing and volume reduction.
- Current literature is inconclusive regarding the impact on functional outcomes and early weight-bearing.
- Further high-quality research is required to develop evidence-based clinical practice guidelines.