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April 10, 2010

Another Learning Opportunity

The scenario is the VAs multidisciplinary amputee clinic. Two doctors run the clinic and I am there to observe. We have a person from the prosthetics department to provide ordering information, and 4 to 6 vendors from area prosthetic companies.

Patients that come to the clinic range in age from their 20s to their 70s. People can lose limbs in a variety of ways. At the VA, you'd think it would be safe to assume that the patient's there lost their limbs in combat, but you'd be wrong. The number one reason people lose a limb is diabetes and infection from a sore than won't heal. Sometimes, civilian life is the most dangerous. From car accidents, bone infections, and sports fracture that don't heal, any variety of life incidents can result in an amputation.

Reasons for patients needing to come to the amputee clinic are numerous, as well. They may be there to have a part fixed on an existing prosthetic limb. They could be be there because they have lost or gained weight and need a new socket. Some patients are new amputees and need to select a vendor to provide them with a new limb. Some patients are more seasoned and find their prosthetic limb is limiting them from a more active lifestyle, qualifying them for a more dynamic appliance. Often, the patients have already established a rapport with a particular vendor and will choose to continue with that person.

One vendor, who I had an extensive conversation with during a break, was an amputee, himself. Having worn a prosthetic limb himself for more than 20 years, he was a fabulous source of information. He was well informed, not only about prosthetic devices themselves, but innovative amputation surgeries, and well versed at trouble shooting problems in existing prosthetic wearers. He's either been through it all or seen it all, and he knows his stuff.

One of the most important part of taking care of an amputee is to examine their residual limb. Look for any areas of redness or other skin changes such as blisters. Blisters result from ill fitting sleeves, loose sockets, or pressure and rubbing from misalignment, and must be addressed immediately to prevent onset of infection. Because so many amputees are diabetic, the body does not heal as quickly or fight infection as readily. Add cigarette smoking to that equation, and healing is slowed even more. Always encourage patients who smoke to consider smoking cessation.

Posted by linda at April 10, 2010 7:36 AM

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