Lower limb amputees who use a prosthesis may develop skin problems on the amputation stump. Because elements of the human body are employed for functions for which they were not planned, fitting a prosthesis is difficult. Many difficulties are caused by the skin/prosthesis interaction. A synthetic material, such as silicone or plastic, is constantly in contact with the skin in this situation. This type of material interaction is not good for skin. One of the most common issues impacting lower-limb prosthetic users nowadays is skin disorders. Around 75% of amputees who use a lower-limb prosthesis have skin issues. Amputees, in fact, have roughly 65 percent more skin issues than the general population. Common skin problems The most common skin issues faced by prosthetic leg users are: • Skin Hygiene • Stump Edema syndrome • Contact dermatitis • Nonspecific Eczematization • Epidermoid cysts • Bacterial and fungal infections • Inter Trigo Reasons: In a prosthesis, abnormal mechanical and thermal conditions are introduced, such as socket contact with the skin. Excessive tension, friction, or heat can cause tissue trauma. Furthermore, perspiration is produced in response to increased warmth, but it is impossible to drain due to the closed prosthetic environment. More heat and moisture soften the skin as a result of this. Another mechanical issue that arises with a prosthetic socket is pressure. Certain areas of the human anatomy, such as the fat pad on the heel, are well-suited to disperse pressure. The natural pressure-distribution anatomy is lost or altered with amputation. As a result, your prosthetist will have to use anatomical locations that aren't well-suited to weight-bearing forces. Socket fit issues can increase pressure and hasten skin degradation. Minor prosthetic changes can typically alleviate pressure sores. However, pressure areas can occasionally be more severe, necessitating time out of the prosthesis and/or a whole new socket fit. Irritant contact dermatitis and allergic contact dermatitis are two more issues that prosthesis users face. When the skin is exposed to a material that causes skin aggravation, one of these things can happen. If the patient's prosthesis contains a known irritant or allergic component, it should be replaced with a different material. Solution: Topical steroids or a barrier cream can also be used to treat. For these diseases, topical treatments such as hydrocortisone and zinc oxide are available over-the-counter (OTC). Dermatitis, if left untreated, can cause persistent inflammation, cellular damage, and carcinogenesis (cancer). Good cleanliness and daily skin examinations are the first steps in avoiding skin issues. Clean any components of your prosthesis that come into contact with your skin on a daily basis. Inspect and clean all sections of your skin that come into contact with your prosthesis on a daily basis. When it comes to recognizing skin disorders, don't rely just on your senses. Many patients have been desensitized to the point that they are unable to detect skin damage. Consult Prosthetist: If you have a skin condition that you can't seem to address or that won't heal, the first thing you should do is consult your prosthetist. The prosthetist can next decide whether the condition can be remedied with prosthetics or other conservative methods. If you don't have a primary care physician or a specialist, the prosthetist may refer you to one. Amputees frequently experience skin problems. Because amputees place a disproportionately high demand on their skin, and because not wearing a prosthesis is frequently not an option, they often overlook the need of skin maintenance and monitoring. Skin problems must be addressed seriously. Start by talking to your prosthetist to figure out what's wrong and, ideally, how to fix it. If your prosthetist is unable to help, you may need to seek the advice of a specialist, such as a dermatologist. References: Niazi, M., Mehrabani, M., Namazi, M. R., Salmanpour, M., Heydari, M., Karami, M. M., Parvizi, M. M., Fatemi, I., & Mehrbani, M. (2020). Efficacy of a topical formulation of henna (Lawsonia inermis L.) in contact dermatitis in patients using prosthesis: A double-blind randomized placebocontrolled clinical trial. Complementary therapies in medicine, 49, 102316. https://doi.org/10.1016/j.ctim.2020.102316 Lyon, C. C., Kulkarni, J., Zimerson, E., Van Ross, E., & Beck, M. H. (2000). Skin disorders in amputees. Journal of the American Academy of Dermatology, 42(3), 501–507. https://doi.org/10.1016/s0190-9622(00)90227-5 Otter, N., Postema, K., Rijken, R. A., & van Limbeek, J. (1999). An open socket technique for through-knee amputations in relation to skin problems of the stump: an explorative study. Clinical rehabilitation, 13(1), 34–43. https://doi.org/10.1177/026921559901300105 Koc, E., Tunca, M., Akar, A., Erbil, A. H., Demiralp, B., & Arca, E. (2008). Skin problems in amputees: a descriptive study. International journal of dermatology, 47(5), 463–466. https://doi.org/10.1111/j.1365-4632.2008.03604.x Klute, G. K., Huff, E., & Ledoux, W. R. (2014). Does activity affect residual limb skin temperatures?. Clinical orthopaedics and related research, 472(10), 3062–3067. https://doi.org/10.1007/s11999-014-3741-4
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