SKIN PROBLEMS OF THE AMPUTEE

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SKIN PROBLEMS OF THE AMPUTEE

Skin problems are fairly common on the residual limbs of amputees. They may develop for a variety of reasons including poor socket fit, incorrect alignment of the prosthesis, poor skin care, or allergic reactions. Skin problems in the amputee often take on one of the following forms: rashes, blisters, ulcers, verrucous hyperplasia, epidermoid cysts or infections.

Rash

A rash can be formed by bacteria, fungus, allergic reaction, or chemicals on the skin. To avoid a rash, clean your residual limb and prosthesis as indicated. If a rash does develop, try cleaning your residual limb more often and using a hypoallergenic soap. You can also take your prosthesis off for a few hours in the middle of the day to allow your skin to dry and heal. If the rash persists for more than a few days or is getting worse, contact your physician. If your rash is an allergic reaction, your physician may prescribe a mild steroid cream to clear up the rash. Alternatively, it may be decided to change the type of liner to a less irritating material or one that will allow your skin to breathe more. For bacterial or fungal rashes, medication is usually required.

Blisters or Sores

Blisters and sores are very common and can occur when there is rubbing on the skin of your residual limb within the prosthesis. A properly fitting socket will normally prevent blisters and sores. It is important to maintain a good socket fit by adding and removing socks throughout the day. If a blister does form on the surface of your skin, care should be taken to avoid opening the blister and the surface should be kept clean. If the blister or sore does not heal quickly, see your prosthetist to have the fit of your prosthesis checked. If the wound still does not heal within two or three weeks, see your physician. Monitor any wound closely for signs of infections such as pus, redness or swelling. If any of these appears, contact your physician. If you have symptoms such as fever, chills, or generalized redness of your leg, contact your physician immediately. If you cannot get in touch with your physician, go to the emergency room of your local hospital.

Verrucous Hyperplasia

Verrucous hyperplasia is the formation of thick, uneven skin over the end of the residual limb that looks very much like a wart. Sometimes this thick skin will crack open, causing a wound as well. This disorder is caused by not having enough pressure at the end of your residual limb. This condition is treated by adjusting the fit of your socket so that there is pressure evenly distributed throughout your residual limb including the area with verrucous hyperplasia.

Epidermoid Cysts

Epidermoid cysts are small sacs of tissue that sometimes form underneath the skin. They can range from the size of

a pea to larger than a golf ball. They are believed to be caused by a combination of clogged pores and skin irritation. Sometimes bleeding will occur within the cysts, giving them a very dark appearance. If an irritating nodule forms under the skin on your residual limb, see your doctor. Usually your socket can be adjusted or redesigned to improve the condition. The cyst may need to be drained and sometimes steroids are injected into the cyst to decrease inflammation.

Sometimes a cyst breaks open on the skin and a white material or a bloody material comes out. If a cyst ruptures, keep it clean on a daily basis as you would an open wound. The cysts should heal quickly. Once again, if there are any signs of infection, see your doctor immediately.

Controlling Odor

"When you wear a prosthesis, your leg will be enclosed much like your foot used to be. If you develop an unpleasant odor on your residual limb, much like that of a sock or shoe, you should not be alarmed. The best way to control the smell is to take good care of your skin and to keep your socket clean. If excessive perspiration is a problem, you can use a spray-on antiperspirant that does not contain a deodorant. (Deodorants can cause rashes in a prosthesis.) If needed, a very strong antiperspirant can be prescribed by your doctor.

Our thanks to Rehabilitation Institute of Chicago for letting us reproduce this article on our site. To learn more please go to the Rehabilitation Institute of Chicago's web site www.rehabchicago.org

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