Unna and elastic postoperative dressings: Comparison of their effects on function of adults with amputation and vascular disease

Objectives: To compare the functional outcome associated with the use of Un na semirigid dressings (SRD) and elastic bandage soft dressings (ED) for ad ults with lower limb amputation. Design: Experimental design. Setting: Inpatient rehabilitation unit of an urban academic medical center. Participants: A successive series of adults with vascular disease who had l ower limb amputation surgery. Subjects were randomly assigned to the SRD (1 2 patients with 12 recent amputations) or the ED (9 patients with 10 recent amputations) group. Subjects in each group were not significantly differen t except for age; those in the SRD group were somewhat older. Intervention: Subjects in the SRD group had Unna dressings applied to the a mputation limb by physical therapists trained in the technique. Those in th e ED group had elastic bandaging by therapists, nurses, family, and themsel ves, all of whom were trained in the technique. Results: Sixty-seven percent of the SRD group and 20% of those in the ED gr oup were discharged from the rehabilitation unit ambulating with prostheses . Of those who received prostheses, time from admission to the rehabilitati on unit to readiness for fitting averaged 20.8 days for the SRD group and 2 8.7 days for the ED group. Comparison of survival curves shows that the tim e from surgery to fitting in the SRD group was almost half that of the ED g roup; 30% of the SRD group was fitted within 34 days, whereas it took 64 da ys for the same percentage of the ED group to be fitted. Conclusions: Unna semirigid dressings are more effective in fostering amput ation limb wound healing and preparing the amputation limb for prosthetic f itting. Subjects treated with SRDs were more likely to be fitted with prost heses and to return home walking with a prosthesis.