Journal of Rehabilitation Research & Development (JRRD)

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Volume 53 Number 6, 2017
   Pages 1121 — 1132

Abstract — Elevated vacuum suspension preserves residual-limb skin health in people with lower-limb amputation: Randomized clinical trial

Cameron Rink, PhD;1 Matthew M. Wernke, PhD;2 Heather M. Powell, PhD;3 Surya Gynawali, PhD;1 Ryan M. Schroeder, BS;2 Jayne Y. Kim, MS;3 Jeffrey A. Denune, CP;2 Gayle M. Gordillo, MD;1,4 James M. Colvin, MS;2 Chandan K. Sen, PhD1*

1Department of Surgery, Comprehensive Wound Center, and Dorothy M. Davis Heart and Lung Research Institute, The Ohio State University Wexner Medical Center, Columbus, OH; 2Ohio Willow Wood Company, Mt. Sterling, OH; 3Department of Biomedical Engineering, The Ohio State University, Columbus, OH; 4Department of Plastic Surgery, The Ohio State University Wexner Medical Center, Columbus, OH

Abstract — A growing number of clinical trials and case reports support qualitative claims that use of an elevated vacuum suspension (EVS) prosthesis improves residual-limb health on the basis of self-reported questionnaires, clinical outcomes scales, and wound closure studies. Here, we report first efforts to quantitatively assess residual-limb circulation in response to EVS. Residual-limb skin health and perfusion of people with lower-limb amputation (N = 10) were assessed during a randomized crossover study comparing EVS with nonelevated vacuum suspension (control) over a 32 wk period using noninvasive probes (transepidermal water loss, laser speckle imaging, transcutaneous oxygen measurement) and functional hyperspectral imaging approaches. Regardless of the suspension system, prosthesis donning decreased perfusion in the residual limb under resting conditions. After 16 wk of use, EVS improved residual-limb oxygenation during treadmill walking. Likewise, prosthesis-induced reactive hyperemia was attenuated with EVS following 16 wk of use. Skin barrier function was preserved with EVS but disrupted after control socket use. Taken together, outcomes suggest chronic EVS use improves perfusion and preserves skin barrier function in people with lower-limb amputation.

Clinical Trial Registration: ClinicalTrials.gov; "Evaluation of limb health associated with a prosthetic vacuum socket system": NCT01839123; https://clinicaltrials.gov/ct2/show/NCT01839123?term=NCT01839123&rank=1

Key words: amputation, elevated socket suspension, perfusion, prosthesis, residual limb, socket, suspension, transfemoral, transtibial, vacuum.


View HTML ?? View PDF ?? Contents Vol. 53, No. 6
This article and any supplementary material should be cited as follows:
Rink C, Wernke MM, Powell HM, Gnyawali S, Schroeder RM, Kim JY, Denune JA, Gordillo GM, Colvin JM, Sen CK. Elevated vacuum suspension preserves residual-limb skin health in people with lower-limb amputation: Randomized clinical trial. J Rehabil Res Dev. 2016; 53(6):1121–32.
http://dx.doi.org/10.1682/JRRD.2015.07.0145
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