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Suggested PROTOCOLS:
FLO-TECH-TOR™ and VCSPS™ Sockets

FLO-TECH-TOR™ Suggested Protocols:

• Physicians
• Prosthetists
• Patients, Nurses, Home Health & Family Helpers
• Physical Therapists
• This link jumps to another page: Flexion Contracture Modifications to the FLO-TECH-TOR™ and Flexion Contracture Suggested Protocols

VCSPS™ Suggested Protocols:

• Prosthetists
• Physical Therapists
• Patients, Nurses, Home Health & Family Helpers

Other Protocols (links jump to another page):

• Transtibial Postoperative Early Fitting & Extended Ambulation Protocols
• Transfemoral Postoperative Early Fitting & Extended Ambulation Protocols

Printable Suggested Protocols (pdf file) includes:

APOPPS FLO-TECH-TOR™ Suggested Protocols: for Physicians and Prosthetists (both sets of protocols on one sheet)

APOPPS FLO-TECH-TOR™ Suggested Protocols: for Patients, Nurses, Home Health & Family Helpers, and Post Surgical Protocols for Physical Therapists (all on one sheet)

VCSPS™ Protocols

If you are unable to view the pdf files, please visit the Adobe Web site for a free download of the current version of Adobe Acrobat Reader.

To order pages by mail: 1-800-FLO-TECH (356-8324)

When used as a Postoperative, Protective or Early Fitting Prosthetic Socket

A licensed or certified prosthetist should be consulted throughout the use of all APOPPS™ sockets.

PHYSICIANS
Suggested SURGICAL and POST SURGICAL PROTOCOLS
(FLO-TECH-TOR™ Protocols):

• Elective surgical length is ideal between 5" and 8" as measured from the mid patella tendon. However the APOPPS™ can be custom made to any size or length and available to your patient in 24 to 48 hours depending upon: 1) time of day when prosthetist places the order (before noon ideal) and 2) shipping schedules.
• The cut edges of the tibia should be well rounded, beveled and smooth.
• The wound (incision) should be cleaned and well sutured.
• Apply Steri-Strips^® and an Adaptec gauze.
• Apply a thin layer of 4" x 4" gauze.
• Apply a non-compressive dressing, evenly and not too thick, from the distal end to approximately 2 inches above the patella.

  All forms of moderate skin cover (elastic bandages, gel liners, webbril^®, etc.) are acceptable within the FLO-TECH-TOR™.

• Roll the appropriate size sterile post-op fitting sock (or stockinet) up to the proximal edge of the non compressive dressing.
• The prosthetist may continue the application process from this point.

The FLO-TECH-TOR™ may be removed at any time to observe the incision, provide range of motion of the knee and allow for patient or staff to change bandages or dressings. It should also be removed, routinely, 2 times per day (once in the AM once in the PM). The outer amputation sock should be changed to a clean dry sock. This will allow the outer sock to wick away moisture and other fluids.

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PROSTHETISTS
Suggested POST SURGICAL PROTOCOLS
(FLO-TECH-TOR™ Protocols):

• Apply the waist belt with extension aide.
• Roll the post-op fitting sock (or sterile stockinet) up high enough to fold over the top of the protective socket and secure it to the extension strap portion of the waist belt (temporarily) or use a non allergic spray adhesive to secure it to the thigh.
• Apply a reticulated polyurethane distal end pad.
• Apply an amputation sock over the reticulated pad, tall (long) enough to fold over the top of the protective socket.
• Apply the FLO-TECH-TOR™ (loosely fit) as a deterrent to swelling, injury and potential flexion contractures
• Secure fork strap to the extension strap with minimal upward pressure. The mid patella strap should be loose enough to slide a finger under the strap when the patient is NOT ambulating.
• The side(s) may be heated and shaped to the contours of your patient (bulbous distal tissue).
• The mid patella tendon strap and all Velcro^® compatible Neoprene^® bands must be tightened before ambulating and loosened after ambulating.
• The APOPPS™ Universal Frame Outer Socket (UFOS™) should be kept in the Physical Therapist's possession until the physician has prescribed its use on a regular independent basis.

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PATIENTS, NURSES, HOME HEALTH & FAMILY HELPERS
Suggested POST SURGICAL PROTOCOLS
(FLO-TECH-TOR™ Protocols):

*Daily Hygiene, Range of Motion and Transfer Recommendations:

• *Remove the FLO-TECH-TOR™ socket 2 times per day.
• *Remove the outer fitting sock (or stockinet) and the polyurethane distal end pad.
• Examine (do not remove) the innermost post-op fitting sock (or sterile stockinet) for signs of excessive bleeding or drainage
  • If excessive blood or drainage is found, contact the physician Immediately.
  • If only mild spotting is noted make a record and proceed.
  • Record the size and location of the spotting.
  • If the spotting becomes excessive at some later point contact the physician.
• Wash the reticulated distal end pad with an anti-bacterial soap; rinse well, dry the pad by gently compressing it in a towel
  (DO NOT WRING),
• reapply the pad and a clean dry outer sock over the pad.
• Re-apply the FLO-TECH-TOR™ socket.
• The strap at the mid patella tendon (just below the knee) should be loose enough to slide a finger under it.
• When standing the strap and the Velcro^® compatible Neoprene^® bands should be tightened.
• When in bed or reclined in a chair the mid patella tendon strap should be loose enough to slide a finger under it.

*THE COMPLETE HYGIENE PROCESS SHOULD TAKE NO LONGER THAN 20 MINUTES EACH TIME.

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PHYSICAL THERAPISTS
Suggested POST SURGICAL PROTOCOLS
(FLO-TECH-TOR™ Protocols):

Daily Use, Rehabilitation and Training:

• Weight bearing MUST be authorized by a physician.
• Patients may begin early contact weight bearing; upon receipt of the FLO-TECH-TOR™, either in a tilt table or by standing on a pillow with a chair supporting the distal socket.
• Patients should be encouraged to begin monitored use of the FLO-TECH-TOR™ in conjunction with the UFOS, as soon as they are able (usually 24 hours to 7 days post-op).
• The extension strap is detached from the FLO-TECH-TOR™ fork strap and secured to the UFOS™ fork strap.
• When the time is right, patients should be encouraged to keep possession of the UFOS™.
• Training, prior to and after receiving the UFOS™, MUST stress: caution, following strap procedure, transfer skills, form (posture and balance), navigating obstacles and being aware of and reporting fitting problems as they develop.
• The patient should return to his/her licensed or certified prosthetist as often as appointments are scheduled.
• The prosthetist, with a doctor's prescription, will provide a VCSPS™ (Variable Circumference Supra Patella Socket [a pre-fabricated preparatory prosthesis]) to be used with the same UFOS™, when the patient is ready for knee flexion and full weight bearing.

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A licensed or certified prosthetist should be consulted throughout the use of all APOPPS™ sockets.

PROSTHETIST
(VCSPS™ Suggested Protocols):

• The VCSPS™ (Variable Circumference Supra Patella Socket) should be worn with the same UFOS™ (Universal Frame Outer Socket) the patient used with the FLO-TECH-TOR™ socket during the rehabilitation phase of treatment and be provided with a physicians prescription.
• The amputation must be healthy and ready for full weight bearing. The prosthetist will insert a firmer distal end pad, if needed, before the patient begins full weight bearing.
• Apply the VCSPS™ very snug. This will not only reduce edema and swelling of the residuum, but will provide a better weight bearing fit. To reduce the distal AP, wrap the distal VCSPS™ strap around the outside anterior portion of the of the UFOS and tighten to the desired dimension.
• The prosthetist will examine the patient, with the VCSPS™, the UFOS™, foot and pylon of your choice, and provide any adjustments required to insure a stable walking alignment.
• The supra patellar or supra condyler area may be molded or trimmed to a SCSP socket or even a PTB type socket.
• Suspension may be altered to accept a suspension sleeve, with a doctor's prescription.
• The prosthetist and the patient should continue to consult with the physician and the physical therapist as the patient progresses toward the time when he/she is ready for a definitive prosthesis.

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PHYSICAL THERAPIST
(VCSPS™ Suggested Protocols):

• Training MUST stress: weight bearing to the prescribed level, caution, form (posture and balance), navigating obstacles, and being aware of and reporting fitting problems (if they develop) to the prosthetist and the physician.
• Training should continue as long as the patient is making progress ­ physically and/or socially.
• Patients should be encouraged to wear the prosthesis as many hours per day as possible (even if they are not using it for walking), and to elevate the leg every time the prosthesis is removed for more than 10 minutes.
• The patient should be as independent as possible, and should return to his/her prosthetist and physician as often as appointments are scheduled.

*Daily Hygiene Recommendations:

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PATIENT, NURSES, HOME HEALTH AND FAMILY HELPERS
(VCSPS™ Suggested Protocols):

• Remove the VCSPS™, the UFOS™ and all amputation socks and examine the skin thoroughly at least (two [2] times per day). Use a mirror if necessary to see all areas of the amputated limb.
• If blisters or broken skin are found, contact the physician immediately.
• If redness is found, gently massage and apply rubbing alcohol to the area during the day and lanolin/aloe based lotion at night (with your physician's approval).
• Wash the socket regularly with an anti-bacterial soap on a sudsy washcloth; rinse with a damp cloth and hand dry.
• The patient should re-apply the appropriate size and ply of amputation socks, long (tall) enough to extend above the top of the VCSPS™ and *re-apply the VCSPS™ and UFOS™ as soon as possible.

*THE COMPLETE HYGIENE PROCESS SHOULD TAKE NO LONGER THAN 20 MINUTES EACH TIME.

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