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Nursing care and treatment of prosthesis leg after amputation
1、 Maintain good posture.
Good stump is the prerequisite of prosthesis assembly. The amputation site and amputation mode should be considered in the operation. The following is about the treatment of postoperative limb care and complications:
1、 Maintain good posture.
To prevent joint contracture and deformity. Because some muscles are cut off after amputation, it will cause muscle imbalance and joint contracture. Such as: hip flexion, hip abduction, knee flexion, ankle plantar flexion, the results will affect the alignment of the prosthesis. Therefore, it should be contraindicated after operation: raising the affected part when lying on the back, putting a pillow in the perineum to make the thigh abduct, taking a wheelchair for a long time, and lifting the stump with a wooden crutch. After operation, the joint should be placed in the functional position, and early functional exercise should be carried out to make the joint flexible without deformity.
2、 Eliminate the edema of the stump.
After surgery, surgical trauma and muscle contraction, venous reflux disorders, will cause stump edema. This kind of edema is temporary. It can be reduced after the circulation of the stump is established. It usually takes 3 to 6 months. However, the use of elastic bandage and reasonable dressing of the stump can reduce the swelling and promote the shaping.
3、 Relieve the pain of stump: there are many causes of pain, mainly including the following aspects:
a) Nerve stimulation during operation
b) Blood circulation disorder of stump
c) The muscles of the amputated limb were abnormally tense
d) There are neuromas in the stump
e) Central nervous system injury
Before assembling the stump, the pain must be eliminated. According to the cause of the disease, surgery, medication, physical therapy, block, acupuncture, injection, psychological treatment, etc. should be taken to avoid the formation of malignant pain stimulation in the brain center. Most of them can be cured, only a few need surgical treatment.
4、 Protect the health of the stump
The skin in the receiving cavity is easy to cause eczema, skin pigmentation, abrasion, ulcer, infection, vesicles, bursa and allergic dermatitis due to compression, friction and temperature changes. To enhance the resistance of the skin, physical therapy can be done if conditions permit. It is necessary to wash the stump with soap water before going to bed every day. If the special nursing liquid and moisturizing lotion are used, the effect of anti-bacterial and inflammation prevention is better.
5、 Sinus or ulcer of stump:
The formation of sinus tract is mostly due to the existence of foreign bodies in the deep part of the wound after infection, such as thick silk thread, dead bone, ulcer, and poor blood supply of the skin; excessive scar tissue at the stump, nerve disturbance and other factors, and in the load-bearing part, the wound healing will affect the prosthesis assembly. The method of treatment is to eliminate the foreign body, treat the wound or amputate the limb again according to the situation.
6、 Bursitis of stump:
Residual limb bursitis, if often in the weight-bearing parts of friction, will continue to grow, difficult to subside, known as abnormal synovial sac. Generally, there is no effect. If the synovial fluid sac is too large or has been infected, it needs to be treated; at the same time, the causes of synovial bursa should be eliminated.
Postoperative scar is inevitable. But also because of improper operation or inflammatory changes can make linear scar expansion, adhesion or contracture, a few people with scar constitution will produce keloids.
8、 Skin diseases:
Folliculitis and tinea are common. It is mainly because of the poor sanitary conditions of the stump, but also because of the poor ventilation and humidity of the receiving cavity, which is easy for bacteria to parasitize.