Tuesday, March 29, 2011

Let's Talk About Suspension

At OPC we believe in an individual approach to prosthetics. The prosthetic devices that are manufactured need to be as unique as the patients who use them. Designing a prosthetic is a mixture of art and science.

Hand picking components to manufacturer custom prosthetics is only part of the process. The patient's suspension system, or the way in which the device is held onto the residual limb, must be carefully chosen. Personal preference, physical issues and strains on the prosthetic must all be weighed when determining the suspension system.

Amputees have a variety of suspension options. Each system has pros and cons which we will explore in today and Thursday's blog. Just like prosthetics, there is no "one size fits all" approach when it comes to prosthetic suspension.

One common suspension system is referred to as "vacuum assist." With this system, the air within the socket is mechanically expelled through a small pump. The prosthetic stays in place through the suction that is created by removing air. A small one-way valve can be depressed to allow air to enter into the socket, breaking the vacuum seal and allowing the device to be removed.

A vacuum system is a preferred suspension system for individuals with decreased circulation. Research has proven that the vacuum suspension promotes circulation by drawing blood into the residual limb. Increasing the blood flow helps to maintain the health of the limb.

Amputees struggling and frustrated with volume fluctuations throughout the day may benefit from a vacuum suspension system. Because the circulation is increased, the limb size does not change as drastically throughout the day. Maintaining an appropriate fit throughout the day reduces the amount of rubbing and "knocking" that can occur within the socket. Many of our patients appreciate that they are no longer reliant upon constant sock changes to maintain a socket fit.

All vacuum assist systems have drawbacks. The vacuum pump, which is frequently mounted into the socket, significantly increases the prosthetic weight. The sheer size of the apparatus must be considered when considering a candidate for this system. The amputee must have enough clearance for the vacuum to be mounted. Many times the component choices are limited because of the size requirements for the vacuum assist pump, forcing the amputee into low-profile designs.

A sleeve must be worn over the top of the socket to maintain the vacuum seal. Some amputees find the sleeve uncomfortable or bulky. Breakdown in the sleeve, the pump or the liner can all result in the suspension system failing. The patient with a vacuum system must remain cognizant and respectful of the technology that they are utilizing.

A vacuum assist suspension, including the Harmony system by Otto Bock, requires skilled practitioners to incorporate the components into the socket design. The practitioners at OPC are experienced fitting these systems. If you have questions about a vacuum assist suspension system, or if you think that you are a candidate, give us a call.

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