Comparison of Postoperative Stump Management: Plaster vs. Soft Dressings

¹ From the Amputee and Problem Fracture Service, Rancho Los Amigos Hospital, Downey, and the Departments of Orthopedic Surgery and Physical Medicine and Rehabilitation, University of Southern California School of Medicine and Los Angeles County-University of Southern California Medical Center, Los Angeles

A study of 182 diabetic, largely geriatric, amputees has been presented to compare three different methods of postoperative care. In random selected groups, a standard soft dressing was compared with a rigid plaster dressing and both were then compared with plaster rigid dressing with an ambulatory pylon attached. The patient population was relatively homogeneous in that they all bore the diagnosis of diabetes. When rigid dressings were applied, they were provided by prosthetists trained specifically for this method of care.

The results of this study support the view that the rigid dressing and ambulation do not deter wound healing and probably are a positive factor in achieving a healed wound and a physical and mental attitude able to accept the prosthetic use. However, additional evidence supports the idea that immediate ambulation may be an early deterrent factor to healing and should be delayed for several weeks. The rate of prosthetic use in this study has been greatly improved when compared with previous experience with essentially the same type of patient population ten years ago. Two major reasons for this improvement are the more frequent use of the below-the-knee amputation and the early use of temporary, total-contact prosthetic devices.

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