What Providers and Patients Need to Know about Shrinkers

Soon after an amputation, the medical team may prescribe the patient with limb loss to wear something termed a "shrinker." A shrinker is similar to a thin sock and very much like the best pair of Spanx ever worn! Typically, the patient with limb loss will begin to wear the shrinker when the sutures are removed and the suture line is securely closed with no open wounds or skin breakdown in the area. The shrinker provides venous stasis, creating a pressure gradient on the residual limb with increased pressure at the distal end and decreased pressure more proximal to the body. This pressure gradient assists in shaping the limb, creating more of a conical shape which will fit more appropriately into a socket. The shrinker also provides protection for the skin as it heals post operatively and even has the potential to desensitize the limb, which may decrease the risk of phantom limb pain.

Shrinkers should be worn at all times until the individual is fit with a prosthetic limb. At that time, it is recommended that the shrinker continue to be worn whenever the liner and/or prosthesis is not worn. This will help to continuously maintain the limb shape and prevent edema throughout the rehabilitation process. Most individuals with limb loss report that the limb shape stabilizes after approximately one year, although it is recommended to continue to wear the shrinker after this time to assist with limb volume shape changes due to water retention, poor food intake, and/or edema.

Several types of prosthetic shrinkers are currently on the market. One type is pulled over the limb as if it were a sock. Another type is pulled over the limb, leaving some material longer than the distal end of the limb. This remaining fabric is twisted once and rolled back over itself to maintain the proper pressure gradient. Each of these styles of a shrinker is available in different sizes. Most often, an idvididual will start with a large size and continue to decrease the size as the edema decreases and the individuals is able to tolerate increased pressure on the residual limb.

It may be difficult to donn these garments, but several options are available to assist. One such device is termed a donning aid and you can find it here: https://www.amazon.com/Juzo-20461-Donning-Slippie-Medium/dp/B00IO3EPRO/ref=sr_1_1_sspa?ie=UTF8&qid=1516765267&sr=8-1-spons&keywords=donning%2Baid&smid=A1C3U2V2RUMVDE&th=1