For this particular phase of his rehab, it would be beneficial to introduce patient education to ensure proper care is implemented early on. By doing so, this will reduce the chances of infections occurring by taking a preventative approach. For instance, during the pre-prosthetic phase, we can teach the patient how to recognize if an infection is occurring and how to manage and care for their wound by participating in proper skin inspection of the surgical site on a daily basis. In addition to this, helping the patient to understand the changes their limb has gone through and what to expect is indeed vital information to share. It is also important to teach the patient to recognize the signs of inflammation in the event that an infection does occur. The patient will also be introduced to ways of dressing the wound, in addition to the proper application of compression sock in preparation for the prosthesis. Pain management education would take place in the pre-prosthetic phase as well, such as determining if the pain is stemming from the surgical site, phantom pain, the effects of the pain medication, or other options that are non-medication treatments.4 It is important to explain to the patient alternative methods of managing pain, especially when the medication is wearing off and before the next dose, or if it is phantom pain as this should not be treated with opiate pain medication. Non-medication treatments that are used with phantom pain, include mirror therapy and TENS.4 Furthermore, during the pre-prosthetic phase, the residual limb will be prepared for the prosthesis by shaping the limb using an ace bandage wrap. The presence of swelling may be reduced by wearing a compression sock, in which the patient will be educated during the pre-prosthetic phase on proper wear throughout their day.
In preparation for the prosthesis, it is also important to include desensitization within the plan of care. This can be done through massaging the sensitive area on the residual limb and the scar as well. The plan of care will continuously involve and promote wound healing, the range of motion within the lower extremity, maintenance of and increasing upper extremity strength, edema management, and self-care. The range of motion during this phase will help to prevent contractures and further deconditioning. Patient education will also include information on how to navigate throughout their home and community environment with the use of assistive device(s) if needed, as they progress towards using their new prosthesis. The patient will also receive information on what will be taking place during the rehab process. For instance, this can include bed mobility, safe transfers, use of an assistive device for ambulation when needed, stretching the lower extremity musculature and active and passive range of motion.