Unna and elastic postoperative dressings: comparison of their effects on function of adults with amputation and vascular disease.
OBJECTIVE
To compare the functional outcome associated with the use of Unna semirigid dressings (SRD) and elastic bandage soft dressings (ED) for adults with lower limb amputation.


METHODS
Experimental design.


METHODS
Inpatient rehabilitation unit of an urban academic medical center.


METHODS
A successive series of adults with vascular disease who had lower limb amputation surgery. Subjects were randomly assigned to the SRD (12 patients with 12 recent amputations) or the ED (9 patients with 10 recent amputations) group. Subjects in each group were not significantly different except for age; those in the SRD group were somewhat older.


METHODS
Subjects in the SRD group had Unna dressings applied to the amputation limb by physical therapists trained in the technique. Those in the ED group had elastic bandaging by therapists, nurses, family, and themselves, all of whom were trained in the technique.


RESULTS
Sixty-seven percent of the SRD group and 20% of those in the ED group were discharged from the rehabilitation unit ambulating with prostheses. Of those who received prostheses, time from admission to the rehabilitation unit to readiness for fitting averaged 20.8 days for the SRD group and 28.7 days for the ED group. Comparison of survival curves shows that the time from surgery to fitting in the SRD group was almost half that of the ED group; 30% of the SRD group was fitted within 34 days, whereas it took 64 days for the same percentage of the ED group to be fitted.


CONCLUSIONS
Unna semirigid dressings are more effective in fostering amputation limb wound healing and preparing the amputation limb for prosthetic fitting. Subjects treated with SRDs were more likely to be fitted with prostheses and to return home walking with a prosthesis.
Wong
C K
CK
New York Presbyterian Hospital, New York, USA.
Edelstein
J E
JE
D000368:Aged; D000671:Amputation, Surgical; D000672:Amputation Stumps; D001458:Bandages; D004487:Edema / Q000517:prevention & control; D005260:Female; D006801:Humans; D007866:Leg / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011182:Postoperative Care; D011184:Postoperative Period; D017755:Prosthesis Fitting; D014652:Vascular Diseases / Q000534:rehabilitation / Q000601:surgery*; D014945:Wound Healing