***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: OBJECTIVE To assess the effect of a plaster cast socket on the healing of open wounds and on temporary  prosthesis fitting  after below-knee amputation because of arterial occlusive disease . DESIGN R and omized controlled trial . SETTING Rehabilitation center , university hospital . PATIENTS All included patients had undergone recent ( in the previous 3 months ) below-knee amputation because of arterial disease and initially had an open stump . Patients were r and omly assigned to two groups of 28 subjects each . The sizes of the amputation scars were 8 to 24 cm2 . Ischemia of the stump was eliminated as a probable cause of delayed wound healing by the inclusion criterion of transcutaneous oxygen tension ( TcPO2 ) of > 35 mmHg . The average age in group I ( the experimental group ) was 65.2 + /- 12.4 ( SD ) years and in group II ( the control group ) 66.8 + /- 10.8 years ( not significant ) . INTERVENTION A plaster cast ( supracondylar-type ) socket was fitted on the stumps of group I patients , interposed with a silicone sleeve . The patients were gradually trained to wear this cast for up to 5 hours a day . They were provided with elastic compression b and ages for the remainder of the time . Patients in group II wore elastic compression b and ages , which were only removed for dressing changes . MAIN OUTCOME MEASURES Time required for stump healing , length of time between amputation and ability to walk wearing a contact socket , and length of hospital stay . RESULTS Group I had a quicker average healing time ( 71.2 + /- 31.7 [ SD ] days compared to the control group 's 96.8 + /- 54.9 days ) and a shorter average length of hospital stay ( 99.8 + /- 22.4 days compared to the control group 's 129.9 + /- 48.3 days ) . CONCLUSION Use of a plaster cast socket leads to more rapid healing of the open stump and to a shorter hospitalization . If there is no stump ischemia , this plaster cast technique is safe To evaluate the use of an  immediate postoperative prosthesis ( IPOP )  for transtibial amputees , we compared patient outcomes from a prospect i ve clinical study of 19 patients managed with an IPOP  with those of a retrospective review of a matched historic control group of 23 patients managed with st and ard soft dressings .  Data were analyzed with the Student 's t-test , and significance was set at P=0.05 . The IPOP patients had no surgical revisions , whereas the patients with st and ard soft dressings had 11 . This was a significant difference . IPOP patients also had significantly fewer postoperative complications and shorter times to custom prosthesis than did controls The purpose of this study was to determine if the removable rigid dressing is more effective in preprosthetic management than the conventional support dressing with elastic b and ages .  Residual limb circumference , independent application of the dressing , tendency of the dressing to remain secure , development of pressure areas , and presence of pain were evaluated in two groups of below-knee amputees . Subjects were r and omly assigned to use either removable rigid dressings or conventional elastic b and ages .  Residual limb circumference was measured three times a week , and the other variables were measured weekly . The results indicated that the removable rigid dressing is more effective in preprosthetic management than the elastic b and age A study of 182 diabetic , largely geriatric , amputees has been presented to compare three different methods of postoperative care . In r and om selected groups , a st and ard soft dressing was compared with a rigid plaster dressing and both were then compared with plaster rigid dressing with an ambulatory pylon attached . The patient population was relatively homogeneous in that they all bore the diagnosis of diabetes . When rigid dressings were applied , they were provided by prosthetists trained specifically for this method of care . The results of this study support the view that the rigid dressing and ambulation do not deter wound healing and probably are a positive factor in achieving a healed wound and a physical and mental attitude able to accept the prosthetic use . However , additional evidence supports the idea that immediate ambulation may be an early deterrent factor to healing and should be delayed for several weeks . The rate of prosthetic use in this study has been greatly improved when compared with previous experience with essentially the same type of patient population ten years ago . Two major reasons for this improvement are the more frequent use of the below-the-knee amputation and the early use of temporary , total-contact prosthetic devices In order to reduce the need for repeated changes of socket due to postoperative atrophy and resorption of oedema simple temporary limbs are required to delay the casting of individual sockets until the stump is more mature . A r and omized study of 95 below-knee amputees was performed with a re-usable temporary one-size prosthesis of endoskeletal type with adjustable tube length . Total contact was obtained by moulding a thin plastic pillow containing small plastic pellets around the stump in parallel connected sections . As air was evacuated the pillow became rigid . The pillow was kept in place about the stump by Velcro b and s. Physiotherapists were able to make all adjustments and ambulate the patient 1–2 hours a day . The training started 2–4 weeks after amputation and lasted for 1–4 weeks . Healing problems due to training did not occur in well healed stumps where training started 3 weeks or more after amputation . No negative influence on maturing of stump , hospital stay and walking ability three months after amputation was found The most popular early walking aid ( EWA ) in the United Kingdom ( UK ) is the Pneumatic PostAmputation Mobility aid or PPAM aid . A disadvantage of this device is that it does not allow a transtibial amputee to flex or extend the knee during walking . The Amputee Mobility Aid ( AMA ) was developed to allow knee movement , enabling transtibial amputees to practise a more natural gait . The benefits of using EWAs include early walking , reduction in postoperative oedema and improvement in patient morale . This pilot study investigated the pneumatic bag/stump interface pressures of the PPAM aid and the AMA . In addition , the range of motion of the knee on the amputated side and the mechanical knee of the AMA were compared . The AMA was found to have higher interface pressures than the PPAM aid during st and ing and similar pressures during supported walking . Subjects using the AMA did flex and extend their knee during walking but through a reduced range of motion . There were no significant differences between the angular movements of the AMA 's mechanical knee and the patient 's knee within it OBJECTIVES To compare the functional outcome associated with the use of Unna semirigid dressings ( SRD ) and elastic b and age soft dressings ( ED ) for adults 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 lower limb amputation surgery . Subjects were r and omly assigned to the SRD ( 12 patients with 12 recent amputations ) or the ED ( 9 patients with 10 recent amputations ) group . Subjects in each group were not significantly different except for age ; those in the SRD group were somewhat older . INTERVENTION Subjects in the SRD group had Unna dressings applied to the amputation limb by physical therapists trained in the technique . Those in the ED group had elastic b and aging by therapists , nurses , family , and themselves , all of whom were trained in the technique . RESULTS Sixty-seven percent of the SRD group and 20 % of those in the ED group were discharged from the rehabilitation unit ambulating with prostheses . Of those who received prostheses , time from admission to the rehabilitation unit to readiness for fitting averaged 20.8 days for the SRD group and 28.7 days for the ED group . Comparison of survival curves shows that the time from surgery to fitting in the SRD group was almost half that of the ED group ; 30 % of the SRD group was fitted within 34 days , whereas it took 64 days for the same percentage of the ED group to be fitted . CONCLUSIONS Unna semirigid dressings are more effective in fostering amputation limb wound healing and preparing the amputation limb for prosthetic fitting . Subjects treated with SRDs were more likely to be fitted with prostheses and to return home walking with a prosthesis To evaluate the effect of wound dressing upon wound healing , fifty-one patients undergoing below-knee amputation using a long posterior myocutaneous flap technic were r and omly allocated into a soft or plaster dressing group . Neither wound dressing technic proved superior , as wounds healed in 85.2 per cent of the plaster dressing group and 83.3 per cent of the soft dressing group 
    Output:
    
Despite the large variability of included studies , this review reveals a trend in favour of rigid and semi-rigid dressings for achieving stump healing and reduction of stump volume .
No conclusions can be drawn with regard to the effect on functional outcome .
The literature is not conclusive on the effects of early weight bearing on stump healing , volume reduction , and functional outcome .