The use of a Dual Compression System (DCS)* For The Treatment of Edema of Amputation Site

Introduction:  Amputations can be a result in patients with serious complex wounds of the lower leg.  Post amputation patient can develop significant edema in the amputated leg especially if pre-amputation they had lower leg edema. 

When uncontrolled, such swelling can interfere with wound healing, cause wound dehiscence, tissue destruction leading to a delay in wound healing and need further surgical debridement.  We describe a method that has produced results in the management of amputation site edema in patient that had wound dehiscence. This consists of compressing with a novel compression wrap that can provide consistent, continuous and comfortable compression to the limb of a fresh amputation site. 

Methods:  We present a case series of four patients whose amputation site, which dehisced because of edema, where managed effectively with the DCS wrap. For each patient, the wrap was applied using the tension indicators on the bandage as it would be used on a lower limb venous insufficiency condition. 

The wound bed was managed with advanced moist wound healing techniques and exudative control. Results:  Images of the amputation sites over time show that each patient’s edema was managed and lowered to levels where the patient achieved wound healing.  Tension on the wound site where reduced leading to quick wound closure and none of the patients required any further surgical intervention.

Conclusions:  The technique of using compression to manage amputation site edema to prevent complications is known. Typically, this is accomplished using ace wraps which do not provide consistent, continuous compression.  However, the use of the new DCS does provide the consistent compression needed for adequate compression to reduce wound bed edema. This system already has been described in literature for edema reduction of lower extremity wounds and has been equally successful in our practice to manage post-surgical amputated edema.