[Criteria for socket type prescription: indications and contraindications of a liner system]. / Verordnungskriterien für Oberschenkelschaftsysteme: Indikationen und Kontraindikationen der Linerversorgung.

BACKGROUND: The prescription of socket type for above-knee-amputees is based on clinical experience. There are no official guidelines. On the basis of treatment statistics and a patient survey, this study shows the indications and contraindications of a liner system. PATIENTS AND METHODS: Treatment statistics including data from the medical reports of 183 above-knee-amputees, who were treated in our clinic from 2003 to 2007 were analysed. 32 patients had a system change between liner- and contact-shaft accommodation and were contacted by telephone. The aim was to evaluate satisfaction with the current socket type and thus be able to compare types. RESULTS: A statistically significant relation in the treatment statistics between the quality of the stump and the socket type can be shown. A mesh graft to cover the stump, extreme volume fluctuation, low activity class and co-morbidities are the main reasons for the use of a liner system. Main reasons for a change to a liner system were the preservation of individual independence, better adhesion and skin problems. CONCLUSION: The developed clinical criteria can help physicians decide which socket type is most beneficial for each individual patient.

Assessment of nutritional status of patients with end-stage liver disease undergoing liver transplantation.

Nutritional assessment factors (including dietary history, anthropometric and biochemical measurements, and evaluation of immunocompetence) were retrospectively reviewed in 74 patients undergoing an initial liver transplantation procedure. The patients were subdivided into four categories on the basis of type of liver disease: chronic active hepatitis (N = 24), primary sclerosing cholangitis (N = 22), primary biliary cirrhosis (N = 20), and acute or subacute hepatitis (N = 8). Our nutritional assessment data indicated that malnutrition was present preoperatively in all liver transplantation groups but that each group had distinct characteristics. The group with primary biliary cirrhosis seemed to have the best hepatic synthetic function despite extreme wasting of muscle and fat. On the basis of all criteria, the group with acute hepatitis was the most malnourished of the various disease groups. Aggressive nutritional support, which includes adequate intake of nutrients and supplementation of vitamins and trace minerals, should be encouraged for all potential liver transplant patients.