Wound management and early prosthetic rehabilitation

对于受肢体丧失影响的人群，承窝和残肢之间的界面是假肢系统中最复杂但最重要的部分之一，以实现康复的潜在生活质量改善。这种承窝/身体界面在使用者的舒适性和假肢的控制以恢复活动性方面起着重要作用。这对于软组织尚未适应假体使用的初次截肢者尤其如此，并且术后治疗和康复中的可用替代方案通常基于低质量证据。因此，伤口愈合、其管理和软组织健康通常，对于加快康复过程和增加结果潜力至关重要，因此是该提案的主要驱动力。实践主要依赖于“手工”铸造，其中假肢接受腔是单独设计的。手工将巴黎石膏包裹模型应用于残肢上，以捕捉肢体的独特修改形状。这种形状用于产生正模型，并且根据几种设计范例之一在形状上进一步转换。这些程序是高度不一致的，并基于隐性知识-个人修复师的表现将受到个人经验，技能和信仰的强烈影响。当承窝设计过程不一致时，这导致承窝相对于假足定位的挑战，以确保接近正常的截肢。这个过程被称为“对齐”。这些困难妥协的假肢康复一般，并阻碍发展和建立循证的插座适合criteriaThe拟议的工作将利用动手和不动手的形状捕捉技术。在后一个铸造过程中，将未固化的编织的、基于碳、玻璃或天然纤维的材料施加在残余物上，

For the population who are affected by limb loss, the interface between the socket and residual limb is one of the most complex but important parts of a prosthetic system to realise the potential quality of life improvements of rehabilitation. This socket/body interface plays a fundamental role in the user's comfort and control of the prosthesis to regain mobility. This is especially true for primary amputees where the soft tissue has not yet been conditioned for prosthetic use and the available alternatives in postoperative treatment and rehabilitation are often based on low quality evidence, Therefore, wound healing its management and soft tissue health in general, are essential to speed up the rehabilitation process and increase the outcome potential and is therefore the main driver for this proposal.Present clinical practice relies mainly on "hands-on" casting where prosthetic sockets are individually designed. A Plaster of Paris wrap cast is manually applied over the residual limb to capture the unique modified shape of the limb. This shape is used to produce a positive model and this is further transformed in shape according to one of several design paradigms. These procedures are highly inconsistent and based on tacit knowledge - performance by an individual prosthetist will be strongly influenced by personal experience, skill, and beliefs,6. When the socket design process is not consistent this results in challenges for positioning of the socket relative to the prosthetic foot, to ensure near-normal ambulation. This process is referred to as "alignment". These difficulties compromise prosthetic rehabilitation in general and hinder the development and establishment of evidence-based socket fit criteriaThe proposed work will utilise both hands-on and hands-off shape capturing techniques. During the latter casting procedure, uncured braided , carbon -, glass -, or natural fibre based, materials are applied over the residuum,