Introduction:

At a meeting of the ALS Managers in April 2000 it was agreed to circulate a survey of Silicon and Gel Systems to determine the provision and usage of these items. RehabTech agreed to circulate the survey and collect and collate the results.

There were three groupings addressed:

1. Silicon/gel sleeves used within a socket with a shuttlelock or similar suspension connection – "silicon suspension"
2. Silicon/gel sleeves used within the socket as stump socks (either with other socks or sheaths or on their own) – "silicon socks"
3. Silicon/gel sleeves used outside of the socket as the primary (or secondary) suspension system – "silicon sleeve"

 REHABTech noted three points:

1. There is a range of terminology used for these including SSS, Gel, silicon, PU, Iceross etc, which complicates any analysis.
2. The appropriate responses are for the "functional types" as they have been separated into the three categories noted above
3. If a survey respondent has answered "No" to the "Provision" question, but does provide responses beyond that, the respondent is referring to use of the systems not funded by an ALS system (ie, private funding). The analysis ignored input from "No" respondents as they are not germane to the issue when we are considering funded services.

Question 1

Does your service fund the provision of "Silicon, SSS, etc" suspension, that is a suspension system incorporating a silicon or gel liner with a shuttlelock, lanyon or other suspension system?

Ten of sixteen respondents chose Yes.

The authority for provision showed the Doctor alone six times, Doctor/Prosthetist combination twice, and once each of the Dr/Prosthetist/ALS, Dr and ALS, and ALS alone. Ten of eleven required a justification to be provided.

The data suggests a low frequency of supply. Nine of eleven did not limit the number of replacements allowed.

Seven of the eleven noted that these items were prescribed generically, with no provider restricted to one particular brand but using a range of suppliers.

 Summary

Does your service fund the provision of silicon or gel sheaths, that is a socket liner made of silicon or gel used with or instead of a stump sock?

Thirteen said they did, or would (with justification), provide silicon socks, with three saying no.

Nine of twelve recognised the Doctor alone or in combination with others (five with Doctor alone) as the authorising body, three the Prosthetist alone, one the Physiotherapist (along with the Doctor and Prosthetist) and only one noted the ALS. Eleven of the twelve required a justification.

Frequency of use is still low, but greater than for other products queried. Nine of the twelve had no limitation on the volume provided, although two did note financial limits.

Twelve of Thirteen employed a generic order with only one specifying a brand name. Although one supplier appears in two thirds of the responses, all recorded brand names are represented at least twice.

 Summary

Does your service fund the provision of Silicon sleeve suspension, that is a suspension system incorporating a silicon or gel outer sleeve?

Six of sixteen do not provide this item.

Of those supplying, authorisation included the Doctor in eight of ten cases, the prosthetist was included in five of ten, and the ALS in three of ten. Only 70% required justification for this service.

The frequency of use appears low, but is still noteworthy.

Generic ordering is the norm with three providers having a limit of two and one a financial limit whilst others appear unlimited. One supplier appears on five responses, with others spread throughout.

 Summary

Of the sixteen respondents, two do not provide any of these items, with a further one that does not provide "silicon suspension" or "liners", but does provide suspension sleeves. Another does not provide "silicon suspension" or "silicon sleeves", but does provide liners. Thus thirteen of sixteen provide "gel or silicon socks", eleven of sixteen provide a "silicon sleeve" and "silicon suspension".

From the above, one may surmise that:-

• these items are available from most ALS’s,
• there is usually medical input into the prescription and authorisation,

• these items generally require justification.

The frequency of use is difficult to quantify. It would appear to be low but not insignificant.

Frequency of use is the most difficult area of the survey to define as few ALSs are able to provide this data with reliable accuracy for a number of reasons. Nevertheless, one can conclude that although low in number, there are sufficient occurrences where these items are supplied that Funders are aware of the various providers and types within the groupings.

Conclusion

Although not universally available, these products are provided when justified, in a comparatively small volume, but nonetheless regularly, by the majority of Funders.

Return to Survey home page   Return to ALSA home page
 

last updated 13 September 2000
email: bill.contoyannis@eng.monash.edu.au