This blog post will answer the following questions :
What is a rigid removeable dressing (RRD) and what does it do?
The tool we are talking about is a “rigid removable dressing”. Sounds pretty formidable, right? It is Rigid. It is Removable. And, It’s a Dressing. In short, people can call it an RRD, although that acronym does not necessarily just roll right off the tongue. An RRD however, is a tool that has multiple functions.
Basically, the rigid removable dressing protects your residual limb after surgery. It is like the cast we spoke of earlier, but it is removeable. This is good for skin inspection and protection against impact.
It is like a tangible insurance policy, if you will, against the “what ifs” that happen in life. If and when they do actually happen. Even young, otherwise healthy amputees can fall after a surgery. Accidents happen. Other people who have had an amputation do not have good balance. Then you take away one leg of the table and the equation gets more complicated. Here is a picture of a rigid removable dressing below. This one is a custom, bivalved design. Meaning there is a top and bottom piece that is made so you can place your residual limb inside of the protective shell. The shell, on the inside is made of padding too. From a 3d scan, or impression it can be made to a person’s size and shape. Now if a fall happened on the incision line, or an impact occurred, would you agree that you would be more protected?
The above example, is just one example of what one of these can look like. It has an outer shell which is typically made of a plastic that can be thermoformed over a positive mold of your residual limb. Meaning, the negative mold that was taken of your leg can be filled with liquid plaster, that plaster can solidify and then over the top of that new mold plastic can be formed to your shape. Kind of cool, right? There are always other options though too, such as one that is custom made to you that is made from fiberglass.
Here to the left you will see a rigid removeable dressing that looks a lot like the cast your surgeon might put on after surgery. However, with this kind of protection, a prosthetist usually applies it and will use, fiberglass (the outer layer you see below) prosthetic socks underneath, possibly a shrinker inside and/or possibly some compression grip material to help you reduce in size.
There is also another type of rigid removable dressing that is prefabricated as well.
To put it simply, it was most likely premade before you were an amputee, if your surgery was recent. It can have a cushion on the bottom (distal end) in case a direct hit on the incision area has mistakenly happen. (See picture to the right)
The F Word
The F word in a medical facility is Falls. As discussed earlier anyone can fall. It is quite possible for an older adult especially to fall out of their wheel chair for example, since in many facilities a belt is considered to be a “restraint”. Anyone can fall, especially when they are tired for example or trying to do a transfer from the bed to a chair. We do not wish this to happen, but it does happen.
Other reasons that we see as positives for a rigid removable dressing is that it can protect someone from accidents that can occur from the side. For example, you might have just finished therapy for example and you are watching the news in your room, or at your house.
It is not probably, but it is possible for one of the house staff at a hospital that comes in with a food tray for dinner for example. Although this staff member might absolutely never in their wildest dreams ever wish to bump into you, it is possible. The rigid portion of the dressing will protect you from that lateral impact.
Will you feel that impact? Probably.
Is it way better than nothing? Absolutely.
The “insurance policy” if you will, came to you in the form of the rigid removable dressing and if your incision line was kept intact would you agree that it was worth the temporary measure to protect your residual limb?
Again, does everyone get an RRD? No.
Does everyone need it? No.
Is it better to be ahead of the curve and take the hit after you have it on? Or would it be better to take the fall first, then decide on getting the RRD?
You decide.
We see RRDs most commonly used with below knee amputees. The reasoning here is that an ak amputee might not be in a position where they have to sit on the hard plastic if they are an above knee amputee, as the plastic does go up several inches above your incision line.
Could more people benefit from a rigid removeable dressing, than end up getting it? Quite possibly, yes.
It comes down again to hospital protocol and the doctor’s orders.
Perhaps, you can now inform the medical facility of your protocols as well.
The rigid removable dressing can come in different forms.
In the prosthetic industry, we give patients tangible items. The RRD is one of those items. So, then it means that this RRD has to be fabricated somehow. It can be either fabricated in real time with you at the nursing, your residence or at the hospital or in an office like ours as an out patient. Or, there is also an RRD that is prefabricated. It was most likely made prior to your amputation to be really honest. They have researched sizes for patients and made many of them will fit the “average person” quite well.
We see advantages to both custom and prefabricated rigid removable dressings. For example, it is hard to say anything is a better fit than something that is custom made.
For example, would you rather have a tailor make you a custom suit or dress if they were a master craftsman / craftswoman?
You could see the value there, right?
However, would a prefabricated suit or dress to the job for most people? Yes.
The last advantage of a rigid removable dressing can be found in the lever arm of the product?
What the heck does that mean, right?
A lever arm?
Now the author has drifted off into medical words and he is trying to sound too sophisticated, right? No.
Just follow me along for a minute.
The level arm here that we are talking about is something that helps to hold your residual limb in extension. Meaning, to help you keep your knee straight. Many times, amputees, for whatever reason can develop flexion contractures. In other words, they can develop a position where the knee is flexed and kind of stuck in that position. Many times they are slight contractures that can be handled with a little stretching, but a prolonged contracture can lead to more severe contracture results.
This RRD device can help you maintain that stretch into extension. This is a lesser discussed advantage, but I still see it as one as sometimes amputees get into a position where they can not proceed with therapy or walking on their leg for the first time because they have a contracture at the knee or hip.
We hope this information helps you. Call us with any questions/concerns. 815-717-8970