#RESIDUAL LIMB SKIN#
Therefore, it is important that physical rehabilitation professionals are prepared to recognize and manage common non-emergent skin conditions in this population. Continuously referring patients to a dermatologist for every skin condition may not be practical. During this period, rehabilitation professionals frequently encounter skin ulceration of the patient’s residual limb (RL) related to prosthetic use. Patients with amputation spend considerable time with physical rehabilitation professionals to learn selfcare with their new prostheses. Members of the multidisciplinary healthcare team for individuals with LEA may include orthopedic and vascular surgeons, physiatrists, prosthetists, physical therapists, dermatologists, mental health professionals, and others. Rehabilitation for persons with lower extremity amputation (LEA) is complex and requires an interprofessional healthcare team. High-quality prospective research with larger samples is needed to determine the most appropriate course of treatment when a person with LEA develops an RL ulcer that is associated with prosthetic use. A short bout of prosthetic discontinuance with a staged re-introduction plan is another viable option that may be warranted in patients with ulceration due to poor RL volume management. Surgery or other interventions may also be necessary in such cases to achieve restored prosthetic ambulation.
Prosthetic discontinuance is also a viable method of residual limb ulcer healing and may be favored in the presence of severe acute ulcerations, chronic heavy smoking, intractable pain, rapid volume and weight change, history of chronic ulceration, systemic infections, or advanced dysvascular etiology. Continued prosthetic use is a viable option to manage minor or early-stage ulcerated residual limbs in compliant patients lacking multiple comorbidities. Three EESs were formulated describing ulcer etiology, conditions in which prosthetic continuance is practical, circumstances likely requiring prosthetic discontinuance, and the consideration of additional medical or surgical interventions. Systematic literature review with evidence grading and synthesis of empirical evidence statements (EES) was employed. The purpose of this study was to determine the quantity, quality, and strength of available evidence supporting treatment methods for prosthesis-related residual limb (RL) ulcers. Thus, physical rehabilitation professionals should be prepared to recognize and manage common non-emergent skin conditions in this population.
Continuously referring LEA patients to a dermatologist for every stump related skin condition may be impractical. Patients with lower extremity amputation (LEA) experience 65% more dermatologic issues than non-amputees, and skin problems are experienced by ≈75% of LEA patients who use prostheses.
0 kommentar(er)
