American Academy of Orthotists & Prosthetists

This on-line course will guide you through the results of a Consensus Conference held in May 2003 that was funded by the American Academy of Orthotists and Prosthetists with donations to the Academy's Project Quantum Leap. The multidisciplinary panel of experts convened to review the scientific literature regarding the postoperative management of the lower limb amputee. Five post-operative care strategies previously identified in published literature were adopted for discussion by the conference committee. These strategies included: soft dressings; non-removable rigid dressings without an immediate prosthetic attachment; non-removable rigid dressings with an immediate post-operative prosthesis; removable rigid plaster dressings and prefabricated post-operative prosthetic systems.

Although amputations have been performed for centuries as a lifesaving procedure, the current protocols for care of the person undergoing this life-altering surgical procedure may not reflect the complete and active lifestyle in which the amputee can now engage. Therefore, amputation must be viewed as a reconstructive procedure and the postoperative protocol should be designed to enhance the functional potential of persons forced to undergo this physically and emotionally difficult surgery.

Finally, it was noted by the committee that wound healing is an area of significant controversy and often the definition of healed and healing varies from study to study. This committee has defined categories of wound healing to aid the clinician and researcher in standardizing this often subjective area. Goals of care associated specifically with the amputation, such as pain management, fall prevention, and improved mobility are discussed. In addition, goals associated with overall patient care are also included, such as musculoskeletal reconditioning and cardiopulmonary training, contra-lateral lower limb preservation, emotional care, and minimizing systemic complications.

After completing this on line module the clinician should be able to:

1. Identify and describe the five basic post operative strategies available;

2. Identify and understand the minimum standards of care required to achieve appropriate rehabilitation;

3. Understand the appropriate timing of treatment strategies; and

4. Understand the current literature and research priorities.

The recurrent theme of this Consensus Conference was how to provide the best possible care for the amputee. Although the participants came from various regions of the country and disagreements on appropriate treatment methods occurred, the end result was a composition of research questions that need to be answered if the truth about amputee rehabilitation is to be resolved so that the most effective course of treatment can be determined.

This online course was revised and updated by faculty from California State University, Dominguez Hills in 2009 with assistance from the Northwestern University Prosthetics-Orthotics Center.

Hide Full Description