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The APOPPS & APOPPS-TF by FLO-TECH ® O&P Systems, Inc. Robert N. Brown, Sr., CPO, FAAOP CEO/Research & Design Robert N. Brown, Sr., CPO, FAAOP CEO/Research.

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Presentation on theme: "The APOPPS & APOPPS-TF by FLO-TECH ® O&P Systems, Inc. Robert N. Brown, Sr., CPO, FAAOP CEO/Research & Design Robert N. Brown, Sr., CPO, FAAOP CEO/Research."— Presentation transcript:

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2 The APOPPS & APOPPS-TF by FLO-TECH ® O&P Systems, Inc. Robert N. Brown, Sr., CPO, FAAOP CEO/Research & Design Robert N. Brown, Sr., CPO, FAAOP CEO/Research & Design ®

3 The APOPPS & APOPPS-TF n Adjustable Post-Op, Protective & Preparatory System for Transtibial & Transfemoral Amputations

4 Design Goals – Keep It Simple: n S-afe postop systems n I-mmediate access n M-odular sockets n P-rosthetic –Function & feel n Not One Size Fits All n L-ook custom n Not like Off The Shelf n E-arly, immediate, training & extended ambulation

5 DELAYED HEALING n Main cause: –Disease n Chronic causes: –Disease –Impact injuries –Microscopic injuries

6 The FLO-TECH-TOR n Post-operative, protective or early fit socket provides: –Protection from scraping or impact injuries –Gentle donning and doffing for easy access & attentive wound care –Control and prevention of flexion contractures –Accommodation for bulbous, conical or cylindrical shapes –Monitored early weight bearing & shaping of the residuum –Early & training ambulation n When used with a UFOS

7 The VCSPS n Variable Circumference Supra Patella Socket (PSRD type or Preparatory socket) provides: –Knee flexion mobility –Gentle donning & doffing for attentive wound care –Early, training & extended ambulation n when used with the UFOS –Early & controlled shaping of the residuum –Distal AP closure –Accommodation for fluctuating volume –Independence

8 The UFOS n Universal Frame Outer Socket: –Sized to fit and accept either the FLO-TECH-TOR or VCSPS n Attach the Pylon and foot n Removed in bed n Kept in the Physical Therapy Department The residuum protected by continued use of the FLO-TECH-TOR

9 The FLO-TECH-TOR-TF n Post-operative, protective or early fit socket provides: –Protection from scraping or impact injuries –Gentle donning and doffing for easy access & attentive wound care –Accommodation for bulbous, conical or cylindrical shapes –Distal AP closure –Monitored early weight bearing & shaping of the residuum –Early, training & extended ambulation n When used with a UFOS-TF

10 The UFOS-TF n Universal Frame Outer Socket: –Sized to fit the FLO-TECH-TOR-TF n Attach the Knee, Pylon and foot n Removed when the patient is in bed n Kept in the Physical Therapy Department The residuum protected by continued use of the FLO-TECH-TOR-TF

11 APOPPS TM Specifics n Modular socket system for transtibial amputations, available in: n Lengths of: 5 (child), 7" (youth), 7 (adult) & 9 (adult) & custom n Left and Right n 102 standard sockets, in 11 sizes n Circumferences 8 to 19 & custom –Sockets progress in 1 increments

12 APOPPS-TF Specifics n Modular socket system for Transfemoral amputations, available in: –12" socket length & custom –Left & Right –12 standard sockets in 3 sizes –Circumferences 16 to 27 & custom

13 Selecting the Proper Length n Transtibial Sockets: –MPT to distal end over bandages n Transfemoral Sockets: –Ischium to distal end over bandages If less than 3/4 space between residuum and end of socket - SIZE UP If no stock size available - CUSTOM

14 Selecting the Proper Size n Transtibial sockets: –Approximately 1 week post-op n Circumference: 2 to 3 from the distal end –Measure over light bandages & 2 socks –If measured over skin only, add 1 n Length: MPT to distal end n Left or Right –Prior to amputation n Estimated length n Estimated distal circumference –Add 2 n Left or Right

15 Selecting the Proper Size n Transfemoral sockets: –Approximately 1 week post-op n Ischial Circumference –Measure over light bandages & 2 socks –If measured over skin, add 1 n Length: Ischium to distal end n Left or Right –Prior to amputation n Estimated length n Ischial circumference –Add 2 n Left or Right

16 One APOPPS n Three Prosthetic Programs: n #1, The FLO-TECH-TOR –As protective socket only –Prevent and reduce flexion contractures –Monitor progress with instant access to bandages –Immediate, early or extended wear protective socket –Especially good for revision surgery and to prevent injury

17 One APOPPS n Three Prosthetic Programs: –#2, The Rehab System (FLO-TECH-TOR & UFOS) n Same as FLO-TECH-TOR plus n Early and training ambulation –When the time is right – –Usually 48 hours to 7 days after receipt of FLO-TECH-TOR n Patient interactive –Involve the patient in their rehab

18 One APOPPS n Three Prosthetic Programs: n #3, The Preparatory System (VCSPS & UFOS) n Independent ambulation –2 weeks to 6 months post-op Expedite care: n The APOPPS (FLO-TECH-TOR, VCSPS & UFOS)

19 One APOPPS-TF n Two Prosthetic Programs: –#1, The FLO-TECH-TOR-TF –Use as protective socket only n Prevent scraping & impact injuries n Monitor progress with instant access to bandages n Immediate, early or extended wear protective socket n Especially good for revision surgery and to prevent injury

20 One APOPPS-TF n Two Prosthetic Programs: n #2, The Preparatory System (FLO-TECH-TOR-TF & UFOS-TF) n Early or training ambulation n Extended or independent ambulation –(2 weeks to 6 months post-op) Expedite care: n The APOPPS-TF (FLO-TECH-TOR-TF & UFOS-TF)

21 When should I use an APOPPS or APOPPS-TF n All diagnoses & ages n In the OR n Early postoperative (24 to 48 hours post-op) n 1 to 3 weeks post-op (cast change) n Any time protection or immediate, early or sustained ambulation, is ordered

22 Early Ambulation Protocol n Patient selection –Competent, coherent & cooperative n except in OR –Reasonable family or residence support –Reasonable upper body strength

23 Early Ambulation Protocol n Apply FLO-TECH-TOR or FLO-TECH-TOR-TF n In OR or as soon as prescribed n Examine residuum before attempting distal pressure n Tighten all straps & bands before testing distal tolerance or attempting weight bearing n Apply pressure to distal end (up to 10% of body weight) to determine readiness for weight bearing n Examine residuum after testing distal tolerance n Apply UFOS or UFOS-TF 48 hours to 7 days post application of FLO-TECH-TOR or FLO- TECH-TOR-TF - when the time is right.

24 Early Ambulation Protocol n Weight bearing at 10% –Tighten straps and bands prior to standing n After weight bearing –Examine tissue – check for spotting n Excessive or continuous - contact physician, minor: –Record size & location and monitor n Wash and re-apply reticulated pad n Replace outer sock if soiled –Reapply FLO-TECH-TOR or FLO-TECH- TOR-TF n MPT strap - 1 to 2 fingers loose

25 Early Ambulation Protocol n Progress to 20% weight bearing –Only after 2 days without pain or spotting n Repeat all above daily until patient is full weight bearing –Progress at 10% increments until patient ambulates independently and without incident

26 Practitioner Survey n In December 1998 Survey n 13 Practitioners responded on 94 patients –1 Bilateral –95 Transtibial amputation socket fittings

27 Diagnoses n Diabetes = 55=58.50% n PVD = 32=34.05% n Trauma = 5= 5.32% n Other = 2= 2.13% n TOTAL = 94= 100.00%

28 Application n Patients Room 38 =40.00% n Operating Room17=17.90% n Rehab Dept./Center 16=16.80% n Nursing Facility 9= 9.47% n Recovery Room 5= 5.26% n Patients Home 5= 5.26% n Clinic 3= 3.16% n P&O Facility 2= 2.15% n TOTAL SOCKETS95=100.00%

29 How Was The APOPPS Used? n 95 FLO-TECH-TOR sockets reported –54 (of 95) FLO-TECH-TOR Sockets n For protection only56.84% –41 (of 95) advanced to Rehab System n (FLO-TECH-TOR & UFOS ) 43.16% 100.00% 100.00% –19 Rehab advanced to Prep System n (VCSPS & UFOS ) n 19 of 41 – wearing 2 to 6 mos.)46.34%

30 COMMENTARY n The APOPPS provides & preserves quality. n It offers safe postoperative care (including ambulation) for: diabetic, elderly, circulatory dysfunction & traumatic amputees. n It allows prosthetists to adapt the prosthesis to meet the rehabilitation needs of their patient in a gentle, yet dynamic, and cost effective manner.


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