special subjects
Skin Care of the Residual Limb
Skin breakdown
Skin breakdown usually occurs where there is pressure and/or friction on the skin, especially when the pressure is applied upward and downward or sideways across the surface of the skin. Risk is greater when the skin is wet or moist (such as from sweating). The first sign of skin breakdown is redness and a burning sensation, which may be followed by pain, swelling, blisters, and ulcers. Continuing to wear the prosthesis causes more serious skin damage and can lead to skin infection. Although it is not possible to prevent all skin breakdown, several measures can help prevent or delay skin breakdown: Practicing good stump hygiene: Good hygiene includes washing the residual limb with a mild soap and rinsing thoroughly 2 times a day (more often for people who sweat more than normal); the prosthetist can provide antiperspirant products specifically designed for people with prosthetic devices Maintaining interface and socket fit Maintaining a stable body weight: This is the best way to make sure the prosthesis continues to fit; even small changes in weight can affect the fit Eating a healthy diet and drinking water throughout the day: This helps control body weight and maintain healthy skin. Monitoring and controlling blood sugar (for people with diabetes) Ensuring that the prosthesis is aligned optimally (for people with a lower-limb prosthesis) When people detect signs of skin breakdown, they should promptly see their prosthetist and, if necessary, have the prosthesis adjusted. When possible, people should avoid wearing the prosthesis until it can be adjusted. If the prosthesis is not the cause, or if fitting adjustments do not correct the problem, a doctor needs to do a medical evaluation. 