cuts in Comfort liners

cuts in Comfort liners

Joan Cestaro, C.P.

4/20/2001

Dear members,

We have been experiencing many Comfort gel liners (and Comfort plus liners)
that develop a strange imperfection. The best I can describe this
breakdown is that is appears as though a razor blade has made many small
slices into the gel in a 1 or 2 area. We have many patients experiencing
this and the rep as Ossur has no suggestions or knowledge of its cause. It
was happening to other practitioners first and now to me. This breakdown of
the liner ultimately causes breakdown of the patient's skin. It doesn't
appear to be developing in the same places all the time. Sometimes it's
distally, other times it is midway in the liner- nothing consistent to help
identify a rationale. This breakdown sometimes happens after many months
and we have been associating and rationalizing it with age and wear and
tear. Other times it happens immediately (my patient has had hers for only
2 months) and is luckily under warranty.

I have investigated the types of soaps (lotions, medications) used and the
possibility that these patients may be leaving the liner folded. Speaking
only for myself, I provide very good education to my patients on care and
maintenance. I have not yet found any correlations. On one liner, we
thought the antibiotic used for a patient's ulcer may have been the culprit,
but it doesn't explain the other ½ dozen cases we've seen over these last
few months. Have others been experiencing this? Anyone have suggestions or
know the cause (apparently the manufacturer doesn't!)?

Thanks in advance,
Joan Cestaro, C.P.