Wound management and early prosthetic rehabilitation

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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,