Choudhury S R, Reiber G E, Pecoraro J A, Czerniecki J M, Smith D G, Sangeorzan B J
VA Center for Excellence for Limb-Loss Prevention and Prosthetic Engineering, and Health Services Research and Development, VA Puget Sound Health Care System, Seattle, WA 98108, USA.
J Rehabil Res Dev. 2001 May-Jun;38(3):293-8.
Rigid plaster dressings and immediate postoperative prostheses (IPOP) in patients undergoing transtibial amputations have been reported to reduce pain and healing time, prevent knee flexion contractures, and expedite early ambulation compared to soft dressings. Yet, despite the reported benefits, surgical adoption of (conventional) rigid dressings and IPOP has been inconsistent. The purpose of this study was to determine the current postoperative transtibial amputation dressing practices in VA hospitals. A six-item questionnaire was sent to 134 surgeons at the 117 VA hospitals where transtibial amputations were performed in fiscal year 1999. Responses were received from 83% of the surgeons. During the 1999 study year, surgeons performing transtibial amputations used soft dressings on 67% of patients, conventional rigid dressings with no intent to apply a foot attachment on 14% of patients, removable rigid dressings on 14% of patients, and IPOP (almost exclusively without a foot) on 5% of patients. The application of a rigid dressing or IPOP did not correlate well with the total number of transtibial amputations performed by the surgeon, hospital bed size, or academic affiliation.
据报道，与软敷料相比，接受经胫骨截肢手术的患者使用硬性石膏敷料和术后即刻假肢（IPOP）可减轻疼痛、缩短愈合时间、预防膝关节屈曲挛缩并加快早期行走速度。然而，尽管有这些报道的益处，（传统）硬性敷料和IPOP在手术中的采用情况并不一致。本研究的目的是确定退伍军人事务部（VA）医院目前术后经胫骨截肢的敷料使用情况。向1999财年进行经胫骨截肢手术的117家VA医院的134名外科医生发送了一份包含六个项目的问卷。83%的外科医生进行了回复。在1999年的研究年度，进行经胫骨截肢手术的外科医生在67%的患者身上使用了软敷料，在14%的患者身上使用了无意安装足部附件的传统硬性敷料，在14%的患者身上使用了可移除硬性敷料，在5%的患者身上使用了IPOP（几乎都没有足部）。硬性敷料或IPOP的应用与外科医生进行的经胫骨截肢总数、医院病床规模或学术背景并无良好的相关性。
