For those living with limb loss or difference, properly caring for the remaining skin is not only necessary but essential. Sweat-trapping prosthetic sockets can create an ideal environment for bacterial growth that could cause irritation, abrasion and even ulceration if left unchecked. To ensure the comfort of wearing a prosthesis over time and dodge infection risks – meticulous skin care must be maintained!
Skin Care Routine
While every amputation is different and everyone’s skin has unique needs, there are fundamental skin care elements that should be addressed daily. You should check with your healthcare team before starting a new routine.
· Clean and Dry
Cleansing and drying the residual’s skin is one of the best things you can do for your skin health. Wash the skin with a non-soap cleanser, and completely dry it with a soft towel. Most people do better if they wash/shower at night because that gives the skin time to dry completely before donning the prosthesis the next morning. You don’t want any water to remain on the skin or trapped in a skin fold because it can contribute to bacterial or fungal infections.
There are times of the year when you may need to wash the skin more often. For example, you may need to shower or cleanse your residual skin two or three times a day in the summer due to excess perspiration. If you naturally perspire more, multiple showers or cleanings may have to be part of your normal routine.
You’ll also need to cleanse (often with the same product you cleansed the skin) and dry your socket, liner, and/or sock daily. Make sure they’re completely dry before using them again.
After you’ve washed and dried your residual, apply a nighttime moisturizer to nourish the skin, promote healing, and prevent breakdown. Well-moisturized skin stays flexible and soft, which helps it resist cracking, chaffing, and the development of callouses. Rub the moisturizer into the skin until it’s no longer visible.
· Special and/or Spot Treatments
Some people need a
daytime moisturizer with antibacterial and antifungal ingredients to fight
infection and prevent cracked skin and inflammation. Like the nighttime
moisturizer, rub the daytime product into the skin, and let it completely soak
in before you put on your prosthesis.
If you have pressure spots, you may need to apply a spot treatment or use a liquid-to-powder product that creates a protective barrier between the skin and the liner.
· Daily Skin Inspections
If the skin starts
to break down or gets infected, the quickest solution is often to stay off the
prosthesis. Daily skin inspections are your first line of defense against
immobilizing skin issues.
Every morning and night before putting on and after taking off your prosthesis, use a hand mirror to check all sides and angles of your residual. You’re looking for signs of irritation like red marks that don’t disappear after 10 to 15 minutes, hardened skin, cracks, rashes, and anything else that looks out of the ordinary.
If you have discomfort during the day, take off your prosthesis, and do another skin inspection. You may be able to make a correction on your own by washing and re-moisturizing the skin or changing your sock or liner. However, contact your primary care provider, dermatologist, or prosthetist to discuss your options. Even minor skin problems can be potentially problematic, especially if you have another complicating condition like diabetes.
Dos and Don’ts
· Do not use talcum powder on your limb, as it can ball up and create an abrasion. If you must use a powder, cornstarch is better.
· Do not use alcohol or unknown chemicals/ creams on your limb.
· Remember – your limb is covered all the time, so be very careful if you expose it to the sun. Use sunscreen SPF 30 or better.
· Do not shave your limb; the resulting short hairs get pushed back into your skin, becoming ingrown hairs that can become infected.
· If the skin of your limb opens, go straight to your doctor and prosthetist.
· If you are having a fit problem with your socket, causing skin breakdown, go to your prosthetist for an adjustment. If the breakdown is infected, you will need to go to your physician as well. Stop using the prosthesis; have crutches and a wheelchair for backup.
· If you have a skin breakdown, don’t use a prosthesis. Put a clean dressing/band-aid on the area daily and see your doctor or prosthetist. Don’t “pad” a pressure area, as that creates additional pressure and will make it worse.
· A red spot that turns into an ulcer can mean weeks without being able to use your prosthesis. Stop using the prosthesis and call your prosthetist/doctor.
· If you have reduced or no sensation in your residual limb, check your limb more frequently during the day and don’t put it in hot water or expose it to the sun – it will burn and blister.
Stay on Top of Your Skin Care
A regular skincare routine and daily skin inspections put you a step ahead of potential skin problems. However, the truth is that skin changes over time. You may not struggle with skin integrity now, but that can change with the season or as you age. Healthy skincare habits arm you with the ability to navigate skin-related obstacles before they develop into full-blown hurdles. Always check with your healthcare team if issues arise or before changing your routine. Be consistent and proactive, and you’ll have the best chance at maintaining a full, active lifestyle.
This fact sheet was produced in conjunction with VitalFitSR https://vitalfitsr.com/blogs/news/amputee-skin-care-101-how-to-care-for-residual-skin-and-stop-skin-problems-before-they-start .
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Authors and Contributors
The Amputee Coalition is grateful to the many organizational members and individuals that have contributed to this work. The Amputee Coalition Scientific and Medical Advisory Committee (SciMAC) conducts expert peer view for the Amputee Coalition-commissioned patient education materials. SciMAC contributes clinical and scientific expertise in developing, implementing, and evaluating the Amputee Coalition program and policy initiatives.