Posted on 9th August 2019
Caring for the residual limb is a crucial element of successful rehabilitation. With limb loss often occurring as a result of poor circulation, care of the residuum post amputation is of vital importance. Prosthetic sockets are designed and constructed as a means of transferring the loads of ambulation through the tissues and underlying bony structures. These tissues are not always ideally suited to the high forces that are applied to them during prosthetic use; especially when circulation is not optimum and surgery can leave scars and irregularities that can compromise achieving a comfortable prosthetic outcome.
Prosthetic liners come in many varieties, materials and thicknesses and can fulfil two functions:
The main disadvantage of liners is that they are made of non-porous materials, such as silicone, TPE or polyurethane. This creates a warm, closed environment, which traps sweat and can lead to growth of pathogens and bacteria. Additionally, the sweat acts as a lubricant, leading to increased movement, rubbing and chafing, and adversely affecting prosthetic control. To help overcome these issues Blatchford has developed silicone liners with perforations, permitting sweat to escape, away from the skin, and helping to maintain a drier residual limb.
Researchers at Blatchford in the US and UK have recently published a report evaluating the outcomes of three patients with residual limb skin problems, when they switched from their previous prescriptions to perforated Silcare Breathe liners.
The first case was an active patient who wanted to maintain his sporty lifestyle. Unfortunately, when jogging, sweat would pool in the bottom of his liner, leading to painful blistering along suture lines that would prevent him wearing his prosthesis.
The second case was an avid motocross competitor who after developing an ulcer was advised by his dermatologist to stop wearing his prosthesis for five months to allow the ulcer to heal.
The third case had experienced eight years dealing with skin breakdowns and was considering further surgery.
All of the cases experienced a substantial reduction in sweating on their residual limb and their skin problems resolve – some in as little as three months. The improved environment within the prosthetic socket allowed them to wear their limbs unaffected by the issues that had previously caused them to restrict activities and prosthetic limb use.