responses to skin treatments

responses to skin treatments

John Fergason

9/6/1999

Here are the responses to my question regarding skin toughening for the
LE amputation.



Nothing scientific, but in 20+ years of clinical experience, I
have seen it work wonders. I tell my brittle diabetics, scar tissue
patients, and skin graft patients to aggressively massage their areas of
concern with alcohol. I just saw one of my brittle diabetics today, who
also had reconstructive
surgery leaving a large horizontal scar over mid tib and across the medial
condylar flare. He started alcohol massages 2-3 weeks ago and the change
is visibly evident and he has not had blisters in the adherent scar since.
Another medium is tea. Sounds like a country remedy, but soaking tea bags
on the skin/scar toughens skin from the tannic acid in tea. I have heard
about that one, but have not experienced it. I have lots of good results
from the alcohol massage.

Some amputees I have heard use hydrogen peroxide solution.

The best substance I have seen is tea tree oil. An amputee told me about
it and I have passed the information on to several amputees who claim it
works very well. While not used to prevent skin breakdown, when blisters,
scrapes, and scraches occur the healing time is greatly increased. I have
also found that it is completely uneffective on
anything more than the most superfical of skin problems.

John I have used the cold wet tea bag treatment for 20 some years.
Apply a cold wet tea bag ,(black tea), to the skin area you want to
toughen. for 20 minutes twice a day. The tannic acid in the tea tans the
skin like tanning leather. Do not use this treatment if the skin is open.
It works well on diabetics. It also tends to dry the skin out. If the skin
appears to be dry and scaly apply a moisturizer and discontinue the tea
bag treatment until the skin appears to
be normal again. Do not use a lotion this tends to soften the skin.

I will simply say it is a waste of time; this is only looking for a
solution to a symptom. Why not redesign the socket that changes with the
patient, or is patient adjustable, then there is no need to find a
solution for these problems. There certain areas that no amount of skin
toughening will help, PTPC (Posterior Tibia Plateau Containment) design
will stop medial hamstring problems. I have use PTPC for the last four
years and only have two skin breakdowns, that area is not a problem
anymore. Instead of research in
this field, what we need is development of common sense ideas.

for scoliosis patients I recommend rubbing with a warm moist tea bag.
In theory the tannic acid from the tea will toughen the outer layer of
skin. Have not used on amputees. Years ago the clinic chief at the local
amputee clinic used to recommend soaking your limb in a bucket of Epsom
salts. My partner, Daryl, says, Why don't you put them in a properly
fitting socket? If you make it right, you don't have to toughen up the
skin.;-} Interesting study.

I often advise patients with very thin, fragile, or brittle skin to use
cocoa butter (100% pure, NOT a lotion with cocoa butter). I initially
learned of its use for this purpose from an Orthopedic Surgeon who was
director of an area Rehab Hospital and also ran an amputee clinic. It
really seems to help keep the skin supple while adding density and
toughness. I have also seen
Vitamin E recommended by Doctors for sensitive, fragile or adherent scars.

Medlogic makes a topical application of a medical grade silicone that can
be used to add a protective layer over areas prone to abrasion. Please
keep us posted if you find others. God bless,

I have had good success in using bagbalm to toughen skin and a&d ointment
as a lubricant.

Try Bag Balm, Hoof Alive, or Pickle Brine- Soak the residuum twice per
day, 10 minutes per soak, then continue to wear the prosthesis.