One of the first noticeable changes is size and volume. The residual limb will be remarkably swollen, but as the interstitial fluid (Oedema) begins to be reabsorbed through the lymphatic system and cycled through the venous system.
Residual limb size, volume loss or gain is one of the most important considerations for the Prosthetic practitioner, as it is the main determinant for when to begin manufacturing a prosthetic device.
If the practitioner begins the process too early they run the risk of having to change the definitive (final)socket sooner than expected.
It is a general rule of thumb that newly amputated individuals use their diagnostic sockets/limbs for a minimum of 2 weeks before Prosthetist will consider manufacturing a definitive (Final) socket.
Making the correct decision as to when a prosthetic socket needs to be replaced or manufactured is of critical importance. In contrast to the diagnostic socket, the definitive socket requires high technology materials and components, increasing the costs considerably.
Swollen residual limbs can be controlled through various oedema control strategies:
• Soft dressings with or without elastic bandage wrap compression.( Figure of 8 elastic bandage technique is most common)
• Semi-rigid dressings
• Removable rigid dressings (RRDs) applied over soft dressings.
• Rigid cast dressing in the operating room.
• An immediate or early postoperative prosthesis (IPOP or EPOP)
with an attachment for a pylon and prosthetic foot for early ambulation
There are a few specific criteria that will determine whether an amputee is being successfully managed or rehabilitated to use their prosthetic device:
1. Is the residual limb comfortably contained in the prosthetic socket.
2. Is the amputee stable during the stance phase of gait.
3. Is the amputee able to smoothly transition to the swing phase of gait.
4. Is the prosthesis acceptable in appearance to the amputee.
5. Can the arm amputee successfully utilise and operate their Terminal Device.
6. Is the amputee taught to don and doff their own prosthesis.