Hygiene problems of residual limb and silicone liners in transtibial amputees wearing the total surface bearing socket

Abstract-People with limb amputation deal with thermal stresses in their daily activities. Unfortunately, in the majority of this population, all thermal transfer mechanisms, including convection, radiation, evaporation, and conduction, can be disturbed due to the prosthetic socket barrier, decreased body surface area, and/or vascular disease. The thermal environment inside prosthetic sockets, in addition to decreased quality of life and prosthesis use, comfort, and satisfaction, could put people with amputation at high risk for skin irritations. The current review explores the importance of thermal and perspiration discomfort inside prosthetic sockets by providing an insight into the prevalence of the problem. The literature search was performed in two databases, PubMed and Web of Knowledge, to find relevant articles. After considering the review criteria and hand-searching the reference sections of the selected studies, 38 studies were listed for review and data extraction. This review revealed that more than 53% of people with amputation in the selected studies experienced heat and/or perspiration discomfort inside their prostheses. In spite of great technological advances, current prostheses are unable to resolve this problem. Therefore, more attention must be paid by researchers, clinicians, and manufacturers of prosthetic components to thermal-related biomechanics of soft tissues, proper fabrication technique, material selection, and introduction of efficient thermoregulatory systems.

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Prevalence of heat and perspiration discomfort inside prostheses: Literature review

Ghoseiri¹,

Safari²

2014

“…Improved proprioception, walking ability, and residual limb and socket coupling, as well as less pain and lower interface pressure during stance phase, have also been reported in connection with VAS sockets [13][14][15][16]. However, a lack of evidence exists to support the absolute indication of effect on satisfaction, comfort, performance, mobility, and gait for these socket designs [17][18][19][20][21][22][23][24].…”

Section: Introductionmentioning

confidence: 99%

Systematic review of effects of current transtibial prosthetic socket designs—Part 1: Qualitative outcomes

Safari

Meier

2015

Abstract-This review is an attempt to untangle the complexity of transtibial prosthetic socket fit, determine the most important characteristic for a successful fitting, and perhaps find some indication of whether a particular prosthetic socket type might be best for a given situation. Further, it is intended to provide directions for future research. We followed the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines and used medical subject headings and standard key words to search for articles in relevant databases. No restrictions were made on study design or type of outcome measure. From the obtained search results (n = 1,863), 35 articles were included. The relevant data were entered into a predefined data form that incorporated the Downs and Black risk of bias assessment checklist. Results for the qualitative outcomes (n = 19 articles) are synthesized. Total surface bearing sockets lead to greater activity levels and satisfaction in active persons with amputation, those with a traumatic cause of amputation, and younger persons with amputation than patellar tendon bearing sockets. Evidence on vacuum-assisted suction and hydrostatic sockets is inadequate, and further studies are much needed. To improve the scientific basis for prescription, comparison of and correlation between mechanical properties of interface material, socket designs, user characteristics, and outcome measures should be conducted and reported in future studies.

“…Improved proprioception, walking ability, and residual limb and socket coupling, as well as less pain and lower interface pressure during stance phase, have been reported [13][14][15][16]. However, a lack of evidence exists to support the absolute indication of effect on user satisfaction, comfort, performance, mobility, and gait for these socket designs [17][18][19][20][21][22][23][24].…”

Section: Introductionmentioning

confidence: 99%

Systematic review of effects of current transtibial prosthetic socket designs—Part 2: Quantitative outcomes

Safari

Meier

2015

Abstract-This review is an attempt to untangle the complexity of transtibial prosthetic socket fit and perhaps find some indication of whether a particular prosthetic socket type might be best for a given situation. In addition, we identified knowledge gaps, thus providing direction for possible future research. We followed the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, using medical subject headings and standard key words to search for articles in relevant databases. No restrictions were made on study design and type of outcome measure used. From the obtained search results (n = 1,863), 35 articles were included. The relevant data were entered into a predefined data form that included the Downs and Black risk of bias assessment checklist. This article presents the results from the systematic review of the quantitative outcomes (n = 27 articles). Trends indicate that vacuum-assisted suction sockets improve gait symmetry, volume control, and residual limb health more than other socket designs. Hydrostatic sockets seem to create less inconsistent socket fittings, reducing a problem that greatly influences outcome measures. Knowledge gaps exist in the understanding of clinically meaningful changes in socket fit and its effect on biomechanical outcomes. Further, safe and comfortable pressure thresholds under various conditions should be determined through a systematic approach.