Name of the Procedure:

Common Name: Above-Knee Prosthetic Shrinker
Technical/Medical Term: Prosthetic Shrinker, Above Knee, Each (HCPCS Code: L8460)

Summary

An above-knee prosthetic shrinker is a specialized compression garment designed to reduce swelling, shape the residual limb, and aid in the healing process after an amputee undergoes an above-knee (transfemoral) amputation.

Purpose

Medical Conditions:

• Post-amputation swelling (edema) in above-knee amputees
• Residual limb shaping and volume control

Goals/Expected Outcomes:

• Reduce and control post-surgical edema
• Promote wound healing
• Shape the residual limb to accommodate a prosthetic device
• Enhance comfort and functionality for prosthetic fitting

Indications

Specific Symptoms/Conditions:

• Post-amputation fluid build-up in the residual limb
• Irregular or excessive swelling
• Preparation for prosthetic fitting and use

Patient Criteria:

• Individuals who have undergone above-knee amputation
• Patients with persistent swelling despite other interventions

Preparation

Pre-procedure Instructions:

• Ensure the limb is clean and dry
• Avoid any lotions or ointments before wearing the shrinker
• Consult with a healthcare provider regarding any necessary medication adjustments

Diagnostic Tests/Assessments:

• Physical examination of the residual limb
• Measurement for the appropriate size of the shrinker

Procedure Description

1. Fitting:
   • Measure the residual limb to determine the appropriate size of the shrinker.
2. Application:
   • Gently roll the shrinker over the residual limb, ensuring even compression.
   • Adjust for any wrinkles to ensure a smooth fit.
3. Monitoring:
   • Regularly check the fit and condition of the shrinker.
   • Monitor for any signs of skin irritation or pressure areas.

Tools/Equipment:

• Compression shrinker garment specifically designed for above-knee amputees

Anesthesia/Sedation:

• Not applicable

Duration

• The application process usually takes about 5-10 minutes.
• The shrinker is typically worn continuously, except during hygiene routines and wound care.

Setting

The procedure is usually performed in a:

• Outpatient clinic
• Prosthetics and orthotics facility
• Home setting, with initial guidance from a healthcare provider

Personnel

Healthcare professionals involved:

• Certified prosthetist or orthotist
• Rehabilitation specialists
• Nurses

Risks and Complications

Common Risks:

• Skin irritation or breakdown
• Pressure sores

Rare Risks:

• Circulatory compromise if the shrinker is too tight

Complication Management:

• Immediate removal and reassessment if any issues arise
• Consult a healthcare provider for persistent problems

Benefits

Expected Benefits:

• Reduced swelling and improved limb shape
• Enhanced comfort for prosthetic fit
• Accelerated wound healing

Timeline for Benefits:

• Benefits are typically observed within a few days to weeks of consistent use.

Recovery

Post-Procedure Care:

• Regular inspection of the residual limb for any signs of irritation or pressure
• Adherence to guidance on shrinker wear time

Expected Recovery Time:

• Recovery and adaptation to the shrinker generally occur within a few weeks.

Restrictions and Follow-up:

• Follow up with a healthcare provider for routine evaluations
• Adjustments to the shrinker size as necessary

Alternatives

Other Treatment Options:

• Elastic bandages for compression
• Rigid removable dressings

Pros and Cons:

• Elastic Bandages: More customizable but less consistent pressure
• Rigid Removable Dressings: Provide protection but can be less comfortable

Patient Experience

During the Procedure:

• The application may feel snug but should not be painful

After the Procedure:

• Initial discomfort as the limb adjusts to the compression
• Pain management through over-the-counter pain relievers if necessary
• Enhanced comfort and mobility as swelling decreases