Clinical Practice Guidelines for the Rehabilitation of Lower Limb Amputation

Abstract

Between 2015 and 2017, the US Department of Veterans Affairs and the US Department of Defense developed a clinical practice guideline for rehabilitation of lower limb amputation to address key clinical questions. A multidisciplinary workgroup of US Department of Veterans Affairs and US Department of Defense amputation care subject matter experts was formed, and an extensive literature search was performed which identified 3685 citations published from January 2007 to July 2016. Articles were excluded based on established review criteria resulting in 74 studies being considered as evidence addressing one or more of the identified key issues. The identified literature was evaluated and graded using the National Academies of Science GRADE criteria. Recommendations were formulated after extensive review. Eighteen recommendations were confirmed with four having strong evidence and workgroup confidence in the recommendation. Key recommendations address patient and caregiver education, consideration for the use of rigid and semirigid dressings, consideration for the use of microprocessor knees, and managed lifetime care that includes annual transdisciplinary assessments. In conclusion, this clinical practice guideline used the best available evidence from the past 10 yrs to provide key management recommendations to enhance the quality and consistency of rehabilitation care for persons with lower limb amputation.

Amputación Por Complicaciones De La Diabetes: Protocolo De Atención De Enfermería

“…Los demás puntos que se tratan en el protocolo, como ser datos de identificación del paciente, manejo del dolor, muñón, vendaje, dificultades motrices, atención emocional, autocuidado y cuidados posteriores al alta, adaptación a la prótesis y derivación, están indicados en la literatura [15][16][17][18][19][20] . El dolor es un problema frecuente en el grupo poblacional en cuestión; sin embargo, pocos estudios de investigación abordan la semiología y la atención de Enfermería específica, lo que limita la práctica profesional 21 .…”

Amputação Por Complicações Do Diabetes: Protocolo De Cuidados De Enfermagem

“…Os demais pontos tratados no protocolo, como dados de identificação do paciente, gerenciamento da dor, coto, curativo, dificuldades motoras, cuidado emocional, autocuidado e cuidado pós-alta, adaptação à prótese e referenciamento são elencados na literatura [15][16][17][18][19][20] . A dor é um problema frequente no público referido, porém poucas pesquisas abordam a semiologia e os cuidados de enfermagem direcionados, limitando a assistência profissional 21 .…”

Amputation Due to Complications of Diabetes: Nursing Care Protocol

“…The other aspects addressed in the protocol, such as patient's identification data, pain management, stump, dressing, motor difficulties, emotional care, self-care and care measures after discharge, adaptation to the prosthesis and referral, are listed in the literature [15][16][17][18][19][20] . Pain is a frequent problem in the aforementioned population segment; however, few research studies address the semiology and targeted Nursing care, thus limiting professional care 21 .…”