Cleaning tips for your residual limb and your prosthesis.
This article includes guidelines and reminders to help you care for your residual limb and your prosthesis.
Good hygiene of the residual limb will reduce skin problems. The skin that comes in contact with your prosthesis must be cared for meticulously in order to prevent skin damage such as irritation, skin breakdown, and infection.
The best time to clean your residual limb is in the evening. If this is not possible, always make sure that your skin is completely dry when donning your prosthesis. Dry your skin softly without rubbing. Skin hygiene includes washing your limb at least once a day, with a mild soap such as the daily soap used for your body. Be sure there is no perfume or antibacterial agent in your soap. Care must be taken if you have skin folds or wrinkles. A small cotton swab can be used in these areas.
When washing your limb, take the time to inspect your skin. Check for sores, abrasions or rashes. You can use a mirror for a complete skin examination, or have somebody helping you if you have problems with your vision. Pressure marks from your prosthesis could last a few minutes after you remove your prosthesis. If they last longer than 10 to 15 minutes, you should consult your prosthetist to reassess the fit.
The socket of the prosthesis creates an airtight, warm and damp space where natural body oils and sweat can collect. This creates an environment that encourages the growth of bacteria and the development of infection. Damp skin tends to break down, giving bacteria easy entry into the body. As a result, infections may develop. If your skin is really irritated, chaffed or inflammated, consult your prosthetist or doctor.
Restrain from applying lotions and creams to your residual limb before donning your prosthesis, especially if you use a gel or silicone liner, unless this is specifically prescribed by your prosthetist as part of your donning process. To condition or hydrate your residual limb do not use alcohol-based lotions because they tend to dry out the skin.
Here are a few reminders:
- do not use talcum powder on your limb
- do not shave your limb, because short hairs could become ingrown hairs
- do not use alcohol or perfume creams on your limb
Heavy perspiration is common with the use of gel or silicone liners, particulary during the first few weeks of use. You may need to take your prosthesis off throughout the day to clean and dry your limb. A number of unscented antiperspirants can be effective; however use them with caution since they may cause skin irritation. A few examples of antiperspirants are: Certain Dry, Harid Extra-Dry, Hydrosal Gel and Drysol. Always try the antiperspirant on another area of your body before applying it to your residual limb. For more information, contact your prosthetist or doctor.
To keep your limb healthy, always wear a clean prosthetic interface such as your sock, or liner.
- Nylon sheath : The thin nylon sock or sheath that you wear next to your skin should be changed each day. Machine wash your nylon socks or sheaths in warm water on the delicate cycle, with mild detergent and no bleach. Tumble dry on low heat.
- Socks : Socks should be changed on a daily basis and washed following the directions on the package. Different manufacturers may have different care requirements depending on the fabric used, for example: wool, coolmax, lycra, superwash, etc. Most socks can be maschine washed on the delicate cycle with mild detergent and no bleach, and then tumbled dry on the delicate cycle.
A liner is often used as the first interface between the skin and the inner socket wall of the prosthesis in order to protect the residual limb and provide comfort and/or suspension. Liners can be made of different materials such as silicone, gel, copolymer or urethane.
Your liner should be cleaned daily and rinsed well making sure it is completely free of soap. Soap residue can cause skin rashes. Dry the inside liner with a towel and always return the liner to its normal position (fabric side out or attachment at the end facing out). Allow the liner to air dry away from any external heat sources. The outside fabric will dry overnight if wet.
Consult your prosthetist to find out what type of liner you are wearing.
Silicone liner : Silicone liners are easy to clean since this material does not absorb water
- Mild soap and water should be used (‘’dish washing’’ soap for sensitive skin is recommended)
- If the liner has no outside fabric you can sterilize it in boiling water.
- Alcohol (ethyl or isopropyl) can be used once a week to disinfect the liner, then the liner should be rewashed with soap and rinsed well. Do not soak the liner in alcohol, but instead place a small amount on a soft clean cloth and wipe the liner.
- Bleaches can also be used once a week to help with odors using the following volume proportions : 1 part of bleach to 9 parts of water. The liner should then be rewashed with soap and rinsed well.
Gel or copolymer liner* :
- This type of liner is also easy to clean since this material does not absorb water.
- Some liners have a medical grade mineral oil which helps to moisturize dry skin.
- *Refer to silicone liner
Urethane liner :
- This material absorbs liquids, including sweat.
- A good cleaning program is very important on a daily basis using mild soap and water (‘’dish washing’’ soap for sensitive skin is recommend).
- Alcohol is not recommend.
- Hydrogen Peroxide can be used once a week, or as needed, for a deeper cleaning. The liner should then be rewashed with soap and rinsed well.
- Cornstarch in warm water can be used as well.
- Always rinse all soap residue very well.
Many other prosthetic components will need care. Here are few examples:
Prosthetic sockets: These components need to be washed using a cloth with mild soap and water. Bleach (Javex) can also be used once a week to help with odors using the following volume proportions: 1 part of bleach to 9 parts of water.
Suspension sleeves or belts : They need to be hand washed with mild soap and water.
Prosthetic feet : Stains from shoes or jeans are very hard to clean. Try ‘’MrClean magic eraser’’ or any strong liquid soap. Use these products with caution since the original finish of the foot outer shell could be damaged.
Carole St-Jean CP (c), prothetist,
Institut de Réadaptation Gingras-Lindsay-de-Montréal