Custom Removable Immediate Postoperative Prosthesis

In Brief Many postoperative treatment modalities for the transtibial amputee are in current use. A simple gauze dressing is the treatment of choice for many surgeons. Another option is compression therapy using an ace bandage or stump shrinker. A more aggressive approach would include the use of a rigid dressing or an immediate postoperative prosthesis (IPOP). The latter modality, although documented to offer the highest rate of healing, is possibly the least used because of many factors, including lack of familiarity with the treatment, a fear of placing a hard cast on a vascularly compromised limb, and the need to frequently monitor the wound. The traditional IPOP is a nonremovable cylinder cast. When the residual limb needs to be inspected, the cast is cut off using a cast saw. Another cast is then fabricated if the IPOP continues to be used. This article presents a removable IPOP, designed for the diabetic, peripheral vascular disease amputee, that specifically addresses the needs of the surgeon. In addition, the design permits a proactive clinical team approach, enhancing the treatment of the prosthetist and the physical therapist. Of the many postoperative treatment modalities for the transtibial amputee currently in use, the immediate postoperative prosthesis (IPOP) is one of the least used, though it is documented to offer the highest rate of healing. This article features a removable IPOP designed for the diabetic peripheral vascular disease amputee that specifically addresses the needs of the surgeon, while allowing for a proactive clinical team approach.