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Caring for Your Limb and Prosthesis

Your prosthesis is an important new part of your body. It is a sophisticated tool, designed to enhance your independence, activity level, and mobility. As you gain experience using your prosthesis, you will become more and more dependent on this tool. Decide right now to follow some basic guidelines for keeping it in good working order. Remember, it is a mechanical device, and as such, it will sometimes require maintenance or repair. By visiting your practitioner at least once a year, potential problems can often be detected and then corrected before your prosthesis breaks or becomes unusable. It’s also a great opportunity to discuss the new technologies and upgrades that become available.

Even with good preventative care, your prosthesis can break. If you notice any clicking, squeaking or creaking, call your practitioner right away. They will know about warranties on each component and how to get replacement parts quickly.

Donning and Wearing Your Prosthesis

Your prosthesis is customized specifically to you and your individual needs. Putting on your prosthesis is called “donning.” In donning, it is important for the surface of the residual limb not to wrinkle or bunch in a way that will cause skin damage. Your practitioner will show you the best technique for donning your specific prosthesis and will also recommend helpful donning items such as pull socks, powder and other types of liners.

Wearing your prosthesis and increasing your activity level are two important goals.  Your prosthetist will give you a schedule that gradually increases the amount of time you wear your prosthesis. Your schedule will depend on your specific situation; however people typically start with a couple of hours each day, and over the course of a few weeks, progress up to wearing their prosthesis all day.  Trying to be too active too soon can create problems like skin irritation and soreness. You can avoid unnecessary complications by closely following the schedule your prosthetist gives you. Wearing your prosthesis for extended periods of time is a longer-term goal that is achieved gradually.  Conversely, if you don’t wear your prosthesis enough, other problems can develop, slowing down your progress towards becoming a fulltime prosthetic user.    

Tips

  • Follow all your prosthetist’s instructions.
  • Never hesitate to ask questions; many people keep a written list to take to their next appointment.
  • Wear your shrinker or elastic/ACE bandage when you are not wearing your prosthesis.
  • If you are a new amputee, be careful not to “over do it” by wearing your prosthesis for too long.
  • Closely follow the wearing schedule your prosthetist gives you; this will help you avoid unnecessary complications.
  • For the first several weeks, use an assistive device like a cane or crutch to gradually increase the amount of weight you are placing on your prosthesis.
  • Even when you are not wearing your prosthesis, work at being active and building up your stamina.


Day-to-Day Concerns

Your residual limb

As the connecting point for your prosthesis, your residual limb is very important. Examine it closely each day, and if you have persistent redness or pain, call your practitioner. Simple adjustments to the prosthesis can often correct these issues.

Swelling and volume fluctuation

It is not unusual for the size of your residual limb to fluctuate, especially in the early stages. A shrinker sock is useful to reduce swelling and should be worn when you are not wearing your prosthesis. If the size of your limb reduces, it is often necessary to adjust the fit of the prosthesis. The most common technique involves adding or subtracting the number of prosthetic socks. If your prosthesis doesn’t utilize socks, set up an appointment for an adjustment.

Heel Height

Your prosthesis was designed to be worn with a specific shoe heel height. Switching to a shoe with a lower or higher heel can create a range of problems, from discomfort to safety issues, depending on the type of prosthesis. Talk to your prosthetist before you change your heel height. Also, check your shoe each day to make sure it is securely attached to the prosthesis.

Prosthetic Socks and Gel Liners

Your prosthetist may recommend that you wear a prosthetic sock or cushioning gel liner as a protective layer over the residual limb. Prosthetic socks are measured by their thickness or “ply”, starting at 1-ply and going up to about 6-ply. As the volume of your residual limb decreases over the course of each day, additional layers or plies of socks can be added to keep the socket fitting snugly. For example, if you are currently wearing a 3-ply sock with a 1-ply sock over it (4-ply total) and the socket is loose, you many either add an additional 1-ply sock or remove all socks and replace them with one, 5-ply sock. For some people, multiple plies of socks may limit their ability to feel the limb inside the socket. If you have concerns, call your prosthetist to discuss the situation, and schedule an appointment for an evaluation.

  • Be sure to write down your sock size and the number of socks at your initial fitting.
  • Track any changes in the number of sock ply and report these changes to your prosthetist at your next appointment.

Personal Hygiene and Prosthetic Care

Perspiration

The residual limb can be particularly subject to perspiration as it is enclosed in a plastic socket. This can be a source of odor and bacteria, as well as the culprit behind skin problems. Try sprinkling your residual limb with baking soda, or if needed, apply an over-the-counter antiperspirant such as CertainDri. The more consistently you wear the prosthesis, the more the residual limb will adjust to being inside the socket, with perspiration naturally subsiding. However if you continue to have a problem, consult with your physician or prosthetist. Keep a good supply of prosthetic socks on hand; you may want to change socks more than once a day due to perspiration.

Daily Cleansing

It is essential to clean the residual limb everyday after wearing the prosthesis. Use a mild antibacterial soap, rinse thoroughly with clean water, and gently dry with a towel. Don’t soak your limb, shave your limb or apply creams to your limb. Allow your residual limb to air dry completely before donning your prosthesis.

Examination

When bathing, carefully examine the surface of your residual limb for red or tender areas (pressure points), and any type of abrasion or blister. While this practice is important for everyone, it is essential if you have diabetes or vascular disease. Also examine your sound foot for any signs of injury or redness. Contact your prosthetist at the earliest sign of skin damage.

Socket Care

Your socket is a part of your body and as such, needs to be cleansed daily with antibacterial soap and water or rubbing alcohol. Many people like to do this as part of their nighttime bathing routine, ensuring that the socket and the residual limb have all night to dry. If you wipe out the socket with alcohol, follow that with a wet towel to remove any traces of the alcohol, which can cause dry skin.

Rehabilitation and Teamwork

As a new prosthetic user, you are engaged in a process of rehabilitation that involves a team of key people. You will work closely with your physician, prosthetist, physical/occupational therapist, and others to increase your mobility and your independence.

Your prosthetist will play a key role in your life from this point forward, guiding you on issues related to health, mobility, and overall quality of life. Rely on them as your best resource for answers, guidance and information.

Physical therapy will allow you to learn how to use your new prosthesis correctly and in a safe environment. Over the course of your lifetime you are likely to use several different prostheses. Each time you receive a new prosthesis, always rely on a round of physical therapy to help you make the most of your new limb.

People such as other prosthetic users, friends and family can play important support roles in your rehabilitation. Peer support is a vital part of your rehabilitation, and is especially important if you are feeling discouraged. Ask your prosthetist to connect you with other new amputees and prosthetic users.

Bilateral below knee amputee demonstrates putting on the prostheses. The silicone liners are first rolled onto the residual limbs. After putting the limbs into the sockets, a neoprene sleeve is rolled over the top of the sockets to provide a seal to lock the limbs securely into the sockets.

 
 
Prosthetist with handheld device monitors Rheo prosthetic knee
 
 
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