Clinical Update Regarding Post-Operative Care for Amputees

Nina Bondre, CPO, has prepared a summary report on material presented at the American Orthotic & Prosthetic Association (AOPA) National Assembly in Vancouver late September. Professionals and amputees alike may find this information of interest. Citations and links to the information presented here can be found at the end for those interested in more detail.

Angie Bryl, Mark Hopkins and Jed Newhardt all attended the September AOPA meeting from Dankmeyer. One of the most interesting pieces of information they returned with was a clinical update regarding post-operative care for amputees. There are many methods of handling a person's residual limb following an amputation, and the studies presented at AOPA helped to provide some support and evidence for current practice and to encourage new standards. 

Multiple studies demonstrated that a rigid dressing following amputation were superior compared to soft dressings, both for decreasing time to fitting, and for reducing incidental injury/trauma to the limb during healing (Reichmann et al, 2018). 

Peer visitation during the post-operative phase is also extremely important and currently quite undervalued. In a trial that included individual peer visits for patients that had undergone an amputation, 92% responded positively to the peer visit. In addition, 1-6 months following the visit, 92% still said that their outlook had been improved due to the peer visit. The recommendation from this study is that peer visits should be encouraged and sought after for everyone who undergoes a major amputation (Reichmann and Bartman, 2018).

People who have amputations in fact have a higher fall risk than those who have experienced a stroke, when compared in similar settings of hospitals and inpatient rehabilitation facilities. 3% of those with lower limb amputations who fall end up needing a revision surgery, and half of the revisions will result in a transfemoral amputation as the final level. However, if the patient is wearing a well-fitting rigid removable dressing at the time of the fall, the falls that end up in a revision surgery are eliminated (Gooday and Hunter, 2004).

For more detailed information, these are the links to the relevant documents. Click to access.

Reichmann, J. P., & Bartman, K. R. (2018). An integrative review of peer support for patients undergoing major limb amputation.Journal of Vascular Nursing, 36(1), 34-39. doi:10.1016/j.jvn.2017.10.002

Reichmann, J. P., & Kritter, A. E., Jr. (2018, June). Evidence-Based Post-Operative Care for Transtibial Amputees. The O&P EDGE.

Reichmann, J. P., Stevens, P. M., Rheinstein, J., & Kreulen, C. D. (2018). Removable Rigid Dressings for Postoperative Management of Transtibial Amputations: A Review of Published Evidence. Pm&r, 10(5), 516-523. doi:10.1016/j.pmrj.2017.10.002

Mark Treasure, Dankmeyer's New Radio Personality

Our Western Maryland office in Lavale now has a potential radio personality in clinician Mark Treasure, CP, BOCO! Dankmeyer staff and patients know that Mark is a guitarist and vocalist when he is not in the office serving the needs of area patients, particularly on Sundays at his church with his wife Linda. On October 25th, however, Mark’s voice could be heard very early in the morning on WCBC 107.1, when he “appeared” in an interview with host Dave Norman.

Mark had an opportunity to talk about the history of Dankmeyer (founded in 1954) and the Cumberland area office, which was established in 1974 by Dankmeyer founder, Charles Herbert “Herb” Dankmeyer, a bilateral amputee. (You can read about the history of this office by clicking here.) During the interview, Dave reveals that he was familiar with Dankmeyer, having come to the office as a young athlete for an orthosis in the early Eighties, which he still has and uses! Dave also talks about his own father’s limb loss. Originally scheduled to last for three minutes, the two chatted for ten minutes.

Mark claims he was a little nervous during the interview, but he sounds like a natural to us! You can listen to the interview by clicking here.

Mark welcomed the opportunity to inform people about the services Dankmeyer provides, telling Dave that he and Patient Services Representative Heather Iman live in the area and are ready and able to serve the Western Maryland area five days a week. And Dave knows that because he last saw Mark at church!

This was Mark’s second educational effort in October. Just a week prior, Mark had been a guest lecturer at the Allegany College of Maryland (ACM). Mark lectures annually to Physical Therapy Assistant students, but in October, he spent time with the Occupational Therapy Assistant students.

Congratulations, Rochelle - Certified Orthotist!

We are very happy to share that one of our newest Dankmeyer team members, Rochelle Dumm, is now a Certified Orthotist. Congratulations on this achievement, Rochelle! And as she continues her Prosthetic Residency, (with her new CO credentials!), Rochelle is also joining our Dankmeyer Academy teaching team. Dankmeyer Academy offers a series of courses for professionals, which have been approved by the Maryland Board of Physical Therapy Examiners for 0.1 credits per hour. They have also been approved by the American Occupational Therapy Association for 1 credit per hour. You can read more about the classes Rochelle is teaching by visiting the Dankmeyer Academy page.

Welcome, Robert Brown, CPO!

Dankmeyer extends a warm welcome to Robert Brown, MS, CPO, FAAOP, who has recently joined our staff. He earned his bachelor's degree in orthotics and prosthetics from the University of Texas Southwestern Medical Center at Dallas in 1988. A Maryland resident, he has worked in a variety of settings and with many different patient populations in the area. His clinical passions are pediatric orthotics and lower limb prosthetics. Robb enjoys seeing the impact the orthoses and prostheses he provides have on a patient's mobility and independence. We are excited Robb is part of our Dankmeyer team!

Nominations, Magazine Articles and Interns!

This summer has been a very busy month for a variety of Dankmeyer folk!

Let's start with our Clinical Director, Angela Bryl, CPO.  Angie, who has been with Dankmeyer since 2006, is nominated for the 2018 Woman of the Year in O&P.  Several questions were asked on the nomination form, along the lines of "How has the nominee made significant contributions to O&P and its people?" and "How is she a leader in what she does every day?"  While all of us at Dankmeyer think she should get rated five stars for each of the questions answered, we might be slightly biased.  We do believe that Angie's patients and the professionals she works with outside of Dankmeyer would agree, so please join us in congratulating her for the nomination!  The award will be announced at the annual assembly of the American Orthotics and Prosthetics Association at the end of September.


In other news, an article by Charles Dankmeyer, CPO, appears in the July edition of the O&P News magazine.  Charles discusses the various professional organizations surrounding prosthetics and orthotics.   These different groups contribute to certification, education, community and healthcare legislation in increasingly important ways to all stakeholders in O&P.  "As practicing professional members of the community, we have an obligation to be united in our efforts to improve our profession and thereby improve the quality of life to the community we serve."  You can read the article by clicking on this link.  If you are interested in the entire issue, you can click here.

This last week we also bid farewell to our two summer interns, Clara Romero Tejera and Shaina Patel.  You may have met them when 3DPO introduced them in an earlier post (click here).  Before they left, they wrote a summary of their work here: 

"We are two engineering students from the University of Maryland and we were lucky to have the opportunity of interning with Dankmeyer during the summer.  Throughout our time here we were able to work firsthand with professionals in the Prosthetics/Orthotics field, in turn gaining knowledge in both patient care and prosthetic manufacturing.

In addition, we are developing a 3D-printed swimming prosthesis for an amputee supervised by CPOs.  Our project consists of designing an entire prosthesis via engineering software and then 3D printing the design.

We are beyond grateful on the treatment we had working with Dankmeyer, as they made us feel like family, having the freedom of creation and the ability to ask for help or input whenever we had any questions."

We were particularly impressed by Shaina and Clara's innovative designs for the 3D printed swimming prosthesis. They went through several iterations of designs, putting each through a series of successive tests to emulate use of the prosthesis by an active seven year old child. Simulations were run to figure out where the highest points of stress would be when using the prosthesis. They completed a lot of research on existing designs and then further customized the prosthesis to match the needs of their unique patient. Thanks for spending your summer with us, we wish you the best!