Purpose Below-knee amputation (BKA) has a devastating impact on function, however there is limited evidence to guide which dressing choice promotes better healing and prosthetic use. This multi-centre study (in collaboration with NZ Artificial Limb Service) addresses the question: do rigid removable dressings (RRDs) alter short-term surgical and long-term functional outcomes following BKA? Methodology A retrospective review of all BKAs performed in four tertiary centres between 2009-2022 was carried out. Exclusion criteria were previous contralateral amputations, a subsequent amputation within 12 months, and paediatric cases. The surgical outcomes were length of hospital stay (LOS), return to theatre (RTT) and mortality. The functional outcomes were time to initial assessment (a proxy for stump healing) and prosthetic fitting, and mobility and quality of life scores. Results Of the total 759 cases, 43.9% received a RRD, 44.4% were fitted with a soft dressing, and for 11.7% dressing type was not recorded. There were no differences in LOS, RTT or mortality between the groups. Functional outcome data from Wellington demonstrated the rigid group had significantly shorter times to initial assessment (median difference 19 days, p=0.004) and prosthetic fitting (median difference 17 days, p=0.04). Multi-centre functional data collection is ongoing. Conclusion Time to initial assessment and prosthetic fitting was significantly shorter in the RRD group. These findings are consistent with international literature and guidelines. This demonstrates the need for increased use of RRDs to accelerate healing post-BKA. While a randomised controlled trial may not hold equipoise, this data should be correlated with other multi-centre studies.