What is stump shaping? How to promote stump shaping?

Generally, after amputation, swelling of the residual limb often occurs due to intraoperative bleeding and postoperative lymphatic and venous return disorders. As the swelling gradually disappears, muscle atrophy in the stump causes the stump to become slimmer in shape. After a period of time, the shape of the residual limb no longer becomes thinner, which is called the residual limb shaping. Clinically, when the circumferences of the same horizontal parts of the residual limb are the same after an interval of 2 weeks, it is used as a sign that the residual limb is finalized and that a formal prosthesis can be customized. It takes more than half a year for the residual limb to take shape naturally. Using some methods to promote residual limb shaping can shorten the residual limb shaping time to 2 to 3 months. Generally, there are several methods to promote the shaping of residual limbs:

1. Elastic bandage

① How to bandage the residual thigh with an elastic bandage, see Figure 6.

② How to bandage the lower leg residual limb with an elastic bandage, see Figure 7.

③How to bandage the upper arm and forearm stump with elastic bandage, see Figure 8.

When applying elastic bandage, you should pay attention to:

①The bandage must be elastic and ordinary gauze bandages cannot be used.

② The bandage should not be stretched too much when wrapping. If one roll is not enough, you can use 2 rolls and sew them end to end. When the bandage is used continuously, it should be replaced with a new one in time when the elasticity is lost.

③ When wrapping, ensure that there is sufficient pressure at the end of the residual limb, and be sure to avoid the tourniquet effect caused by circular wrapping.

④ Use warm water (never use hot water) and low-alkaline soap to wash the bandage. Rinse it thoroughly and place it on a flat surface to dry.

2. Wearing temporary prostheses

Temporary prosthesis is a kind of prosthesis with simple structure, easy, fast and cheap to manufacture. At present, the residual limb sockets of temporary prostheses in China are mostly made of plaster bandages. For some residual limbs with large scars, few subcutaneous soft tissues, adhesions between skin and bone, and short residual limbs, plastic residual limb sockets with soft polyethylene foam sponge inner sleeves should be used. When using a temporary prosthesis, a residual limb sock should be put on the residual limb first. As the swelling of the residual limb decreases and the muscles atrophy, the number of layers of the residual limb sock is gradually increased to adjust the volume of the socket and ensure the correct position of the residual limb in the socket.

2 to 3 weeks after amputation, temporary prostheses can be installed after the wound has healed well. The appropriate length of time to use the temporary prosthesis each time or every day should be determined based on the weight bearing and control ability of the residual limb, and the acceptance ability of the amputee, and should be gradually extended. When training to use temporary prostheses, you should always pay attention to the skin damage of the residual limb, and pay attention to adding residual limb socks as the residual limb becomes thinner to maintain the correct position of the residual limb in the socket.

Generally, temporary prostheses need to be used until the residual limb is finalized, and then the formal prosthesis is customized. Early use of temporary prostheses has the following benefits:

① Getting out of bed early can reduce many complications such as pneumonia and urinary tract infections caused by long-term bed rest.

② Early training to stand and walk is a good psychological treatment for amputees.

③Reduce the swelling of the residual limb and promote the shaping of the residual limb.

④ When using temporary prostheses, choose the best solution for prosthetic assembly and understand the individual assembly characteristics to ensure the quality of permanent prosthesis assembly.