Implementation of Lower Extremity Amputee Protocol (LEAP) to Facilitate Early Rehabilitation and Improved Prosthetic Care-Session Recording

Video Transcription

Video Summary

This presentation addresses the critical gaps and opportunities in amputee care, highlighting it as both a public health crisis and an area for impactful intervention. Dr. Akin Beckley opened by emphasizing the disproportionate lack of training and engagement in amputee care among rehabilitation professionals despite the increasing prevalence of limb loss, primarily due to peripheral artery disease and diabetes. He stressed that amputations substantially worsen patients’ functional outcomes and mortality, yet fewer than half receive prosthetics, with significant disparities based on gender and comorbidities.<br /><br />Dr. Kevin Wong discussed perioperative care, focusing on wound management and the importance of limb wrapping post-amputation to promote healing and expedite prosthetic fitting. He reviewed clinical guidelines advocating a multidisciplinary approach coordinated by physical medicine rehabilitation specialists. Key interventions include early mobilization, use of peer support to sustain patient trust, and standardized outcome measures like the 30-second sit-to-stand test.<br /><br />Noel Sater outlined challenges in implementing these protocols at their institution, including resistance due to workload concerns and lack of familiarity. They developed a collaborative working group and used surveys to assess practitioner experience and comfort. Protocol steps such as early consult orders, education, and hands-on training aim to standardize residual limb wrapping and accelerate post-op rehabilitation, drawing on evidence from the LEAP protocol that shows improved prosthetic use and shorter hospital stays.<br /><br />The talk concluded with evidence supporting early mobilization’s safety and benefits and the need for caregivers to coordinate care from preoperative counseling through long-term follow-up. Audience discussion highlighted barriers such as surgical preferences on dressings, prosthetic provider coordination, and variable institutional practices. Overall, this presentation advocates for a culture shift emphasizing early, multidisciplinary, evidence-based amputee care to improve patient outcomes and reduce healthcare costs.

Keywords

amputee care

public health crisis

limb loss

peripheral artery disease

diabetes

prosthetics disparities

perioperative care

limb wrapping

multidisciplinary approach

early mobilization

peer support

LEAP protocol