1. Elevated Vacuum Suspension
Comprehensive insight into prosthetic suspension and volume management

2. What is elevated vacuum
Past/present of suspension systems
Total contact vs PTB
Knee sleeve
Why not just pin suspension?
Fitting basics of elevated vacuum
Swing/stance…………positive/negative

3. Potential issues with pin suspension
History of Pin
Swing/stance
Volumetric issues
Pistoning
Shear force vs liner matrix
Benefits

4. Suction vs. Elevated Vacuum
Benefits of elevated vacuum in comparison
Mm/Hg differences
How can I tell which is which?

5. Indications for Elevated Vacuum
Functional level
UE mobility/dexterity
Compliance

6. Contraindications Unmanaged medical status Poor compliance
Dialysis patients

7. Elevated Vacuum Pumps Mechanical Electronic User activated
Weight activated

8. Interfaces Polyurethane lines (PUR) Silicone lines
Thermoplastic Elastomer liners (TPE)
Skin fit

9. Cold Flow Thermodynamics of PUR
Stress ball
Total contact
Vascular benefits

10. Which pump is best?
Dynamic pumps have been shown clinically to provide superior outcomes.

11. Casting and Modifying Vacuum Casting ROM considerations
Total contact modifications
What about bony prominences?
Distal reduction

12. Fitting/alignment protocols
Initial contact/heel compression
Vertical compression at stance
Are the hips level?
Torsion
What to look for…

13. Volume Management Vacuum/Suction Pin Suspension Socks = not padding
Volumetric changes
Minimalist approach to volume management
Baby hats
TEC Spots
Pin Suspension
Fitting socks
Shrinker
Volume changes during activity
The Matrix factor

14. ALL LIMBS ARE NOT CREATED EQUAL
Custom liners
SPOTS

15. Sounds perfect but……….. Characteristics which can cause problems
Lack of total contact (hyperplasia)
How to check for total contact distal
Pump maintenance

16. When to call the prosthetist?
Things that are alignment/mechanical related that are causing deviations
Common issues
lack of suction
Socket discomfort

17. Mechanical System Comparison
Knee sleeve vs no sleeve
Harmony vs Unity system

18. Future of vacuum High friction interfaces Weight considerations
3D printing?
Why plaster is superior to CAD/CAM
Pressure sensitive interfaces?

19. Questions ?