The Use of Rigid Removable Dressings for Juvenile Amputees: A Case Report
BARRY GENDRON, D.O. AND KAREN L. ANDREWS, M.D
Rigid removable dressings (RRD), as described by Dr. Wu, provide rapid residual limb shrinkage, prevent edema, provide soft tissue immobilization, decrease wound pain, prevent trauma to the residual limb and decrease the length of rehabilitation for adult amputees. Traditionally, immediate postoperative prostheses are used for juvenile amputees. This is a case showing the use of a RRD for a juvenile amputee. A 9-year-old boy with no past medical history sustained a crush injury to his left leg. He required a below knee amputation with skin grafting at the distal residual limb. He was discharged from the acute care hospital with no dressing or instruction in wound care. When seen in evaluation at our institution, a RRD was recommended for his poorly healing residual limb. The RRD was fabricated 35 days after initial injury. Wound healing was achieved 14 days later. A RRD allows frequent wound inspection and provides progressive compression, both to shape the residual limb and decrease post-operative edema. In addition, it protects the wound during ambulation, normal childhood playing and mat exercises. The RRD also helps to teach the child and family principles of sock management. The RRD is a beneficial technique for the preprosthetic management of the juvenile amputee.
University of Medicine & Dentistry, New Jersey Medical School & Kessler Institute for Rehabilitation, 1199 Pleasant Valley Way, West Orange, NJ 07052A