Skin that comes in contact with the prosthesis must be carefully maintained to skin damage such as irritation, skin lesions (which lead to wounds) and to prevent an infection.
(See also Overview of arm and leg prosthetics.) Skin that comes in contact with the prosthesis must be carefully maintained to skin damage such as irritation, skin lesions (which lead to wounds) and to prevent an infection. Usually provide exactly the disturbances that have put at risk of amputation patients such. B. blood vessel disease and diabetes that interfere with blood flow to the lower extremities, including an increased risk of skin damage and infections after an amputation. Some of these diseases (eg. As diabetes) and others (eg. As neurological disorders) affect the skin perception, so that patients often do not even notice when the skin is cracked or developed an infection because they can feel no pain. These patients should remove their prosthesis several times a day to check their skin for redness and other signs of injury or infection. Other patients should take their skin at least once daily inspected. Skin problems can be serious and should be investigated and dealt with as required by the doctor and the restorative dentist. As patients become familiar over time with recurrent problems, they are always better able to recognize what problems are of a minor nature and can be treated yourself. All skin symptoms, however, are unusual, persistent, painful or worrying in other ways, should be assessed by a doctor. Prevention of skin injuries The skin adjacent to the prosthesis tends to crack, because the prosthesis applies pressure to the skin, rubbing, and there may be between the residual limb and the prosthetic socket to an accumulation of moisture. The first signs of skin damage is a redness, cracks, blisters and ulcers may follow. If the skin tears, the prosthesis is often painful or it is impossible to wear them for long periods. Infections can develop. An undetected or not professionally treated infection can lead to another surgery (revision surgery). Several measures can help prevent skin damage or delay: It is important an interface that fits well. But even with a good fit problems may occur. The remaining limb changes throughout the day in shape and size, depending on activity, diet and weather. So there are times when the interface goes very well and times when it fits less well. The patient can counter by improving the fit by changing to a thicker or thinner insert sock. But the change of the remaining limb can be compensated not always what often leads to inevitable skin damage. In this case, the patient should consult a prosthodontist to better adjust the interface immediately. Skin damage is often the first indication that the prosthesis must be re-adjusted. Maintaining a stable body weight is the best way to ensure that the prosthesis still fits. Even small changes in weight can affect the fit. A healthy diet and drink plenty of water helps to stabilize the body weight and maintain a healthy skin. In patients with diabetes monitoring and control of blood glucose is important. In patients with a prosthesis of the lower limbs avoiding changes in posture can help. Such changes can lead to skin damage, because then pressure is applied to other places. Wearing different shoes can change the posture. For example, the heel can be used in different shoes have a different amount or a different padding (z. B. hard and not soft). If the prosthesis is adjusted, patients can minimize potential changes in posture by wearing similar shoes. When patients see signs of skin damage, they should immediately contact their doctor and their prosthodontist. Patients should not wear their prosthesis as far as possible until it has been reset. the skin, the stem of the prosthesis infections creates an airtight, warm, moist and closed space, in the body oils and perspiration can accumulate – an environment that promotes the growth of bacteria and the development of infections. Moist skin tends to crack, so bacteria can easily penetrate the skin. Infections are the result. Signs of infection are skin sensitivity, erythema, pustules, ulcers or necroses and purulent discharge. A bad smell may indicate an infection or poor hygiene. Minor bacterial infections can develop into a cellulitis and lead to an abscess; In such cases, patients may have fever and general malaise. Any signs of infection should be investigated immediately. Patients should be instructed to consult a doctor if the following symptoms: The remaining limb feels cold (which suggests a reduced blood flow). The affected area is red and tender sensitive. The affected area gives off a bad smell. Lymph nodes in the groin or the armpits are enlarged proximal to the remaining limb. Pus or thick secretions is present. The skin is soft and gray or black (which speaks for gangrene). The treatment of bacterial infections ionene usually involve a local cleaning and topical antibiotics. Sometimes a debridement or oral antibiotics, or both are required. In general, the prosthesis should not be worn until the skin infection has healed. Erythema can show serious medical problems that need to be diagnosed by a doctor and treated. Patients should learn how to prevent infection. You should wash the remaining body part with unperfumed, colorless, antibacterial soap, at least once a day. Patients who sweat a lot or who are prone to skin rashes or infections should be washed frequently. Deodorants can be used, but it should be added to any perfumes or other additives; Sprays with <15% aluminum chloride are freely sold, compositions having a higher proportion of aluminum chloride may be prescribed. The prosthetist will recommend a lubricant or a lotion that is compatible with the material of the interface terminal. Some modern materials used in the socket interface design, can be damaged by long-term use of skin lotions, so it is best to follow the recommendations of the orthopedic technician or the material manufacturer. Each part of the interface which contacts the skin - the shank, the prosthetic sock or the insert (washing of the insert) - must be washed thoroughly every day with hot water and antibacterial soap. Deposits and prosthetic socks should be dried thoroughly before wearing. Soap residues in the shaft or in the insert can cause rashes, so patients need to be sure that both were sufficiently dried. An itchy rash usually indicates an irritation or an allergic reaction towards, not an infection. A doctor may prescribe a cream or ointment for skin rashes. Washing the insert A thorough washing of the insert prevents skin irritation, rashes and infection. The washing of the insert with the outside to the outside (not inverted) is recommended. The liner must be washed with hot water and antibacterial soap and are soaked for 30 seconds in the solution before it is flushed out. The deposit is rinsed repeatedly with hot water until no soap is present, then the hot water is poured out. It must be ensured that the insert is completely dry before it is used. Once a week is applied after washing the pad with isopropyl alcohol soap on the inside of the liner and then rinsed with hot water. If patients can identify a fungal infection, they should apply a non-prescription antifungal cream. However, if the diagnosis is not clear or if a fungal infection is, they should see their doctor. Avoid other skin problems Ingrown hairs and folliculitis, although they are not dangerous, can cause considerable pain and discomfort. It may be advisable to not shave the hair on the remaining limb. A verrucous hyperplasia (rough, warty elevations), usually at the distal end of the residual limb, can result from a poorly fitting interface. This condition often occurs due to improvements in prosthetic design and fitting techniques. Left untreated, the disease can lead to serious infections. If bumps occur, the warts are similar, patients should consult their restorative dentist immediately to check the fit and if necessary re-adjust the interface. Then the doctor should treat the verrucous hyperplasia.