Early trans-tibial oedema control using polymer gel socks.

Abstract

The aim of this investigation was to determine if early trans-tibial oedema control, by polymer gel socks prior to the fitting of a shrinker, could enhance trans-tibial stump volume reduction. Sixteen (16) adults, following unilateral trans-tibial amputation, were randomly allocated into 2 groups and baseline volume measurements taken of their stumps. The control group followed the normal removable rigid dressing programme, while the experimental group wore a polymer gel sock in conjunction with the removable rigid dressing. When wound healing permitted fitting of a shrinker, use of the polymer sock was discontinued and a stump volume measurement was taken. The shrinker was worn for a minimum of 2 days before casting for a prosthesis and a final stump volume measurement taken. Volumes were measured by water filling casts taken of the stump and calculated as a percentage of the baseline volume and the rate of volume reduction calculated. Two t-tests for unequal variance (2-tail, alpha=0.05) were used to compare the rate of percentage volume reduction between the groups, for the trial period of baseline to shrinker fitting and baseline to casting. A statistical difference was observed for the period of baseline to shrinker exceeding the 95% confidence limit (p<0.05). No significant difference was detected for the overall period of baseline to cast. It was concluded that early oedema control by polymer gel sock could enhance stump volume reduction, prior to a shrinker. It was also found that no volume advantage was carried over to the time of casting for a prosthesis.