special subjects
Edema of the Residual Limb
Introduction
Even after the residual limb matures 18 to 24 months post amputation, edema can still occur. Having a well-fitting prosthesis socket is the best way to maintain a consistent residual-limb size and volume. Measures that can be used when not wearing the prosthesis include applying external compression with Elastic bandaging An elastic compression garment The viscoelastic interface used when wearing the prosthesis It also helps to follow a consistent nutrition and exercise program and do exercise and/or physical therapy to maintain muscle mass. Edema is much less of a problem when the amputation procedure is done in a way that preserves some active function of the transected muscle. In hot and humid weather, the residual limb may swell and sweat, making the prosthesis hard to put on. Showering, or immersing the residual limb in cold water for 3 to 5 minutes, and patting it dry immediately before putting the prosthesis on may help. After the prosthesis has been on for 5 to 15 minutes, it should be removed and immediately put back on. This strategy helps get the residual limb properly positioned within the socket. If cold immersion is not readily available, wrapping the residual limb with an elastic bandage or wearing the viscoelastic interface and elevating the limb for 20 minutes or more helps. Although prosthetic suspension systems that hold the prosthesis in place using vacuum (created by an electric or mechanical vacuum pump) might be expected to cause edema, they do not when the socket fits optimally. (See also Overview of Limb Prosthetics .) 