Trimming AK liner responses

Trimming AK liner responses

Scott McAllister, BEP

I sent an inquiry to the list a few nights ago about how to trim an AK liner.
 Many practitioners asked if I would post the responses. They are listed
below, with one space separating each. Thanks to all who responded.

Scott,
Cut it from perineum to troch.. Have client donn, mark (dot) both, then
cut. Liner will lengthen when pt loads, but do be positive you leave some
overlap. Cut too short and you'll buy another.
Jeff McDonald

Scott,

I think it is a matter of preference and depends also on the type of liner. I
have one Transfemoral who is highly active and doesn't like his Dermo liners
cut at all. Generally however, I try to cut them so they can roll over the
edge of the socket about 3 or 4 cm.

Eddie White, CP

I have used a straight edge with a NEW razor blade and usually cut at a
slight angle from the perineum to the trochanteric region for the
anatomically correct fit.
Steve Fries, CPO, (L)
Fort Myers, FL

I have been cutting them at the angle and distal to the trimline.
They then wear a 1 ply or 3 ply over liner to be a separater between
socket and liner edge. Works well.
  Tom CPO

i think it depends on what you have for a length to work with. if it's a
short residual limb the more purchase you can get the better. with a longer
residual limb i'll cut straight across. luke richards

I prefer to cut at an angle (curved to avoid any sharp turns at the start and
end of the cut). If you have the length available, stay a few inches below
the perineum. The proximal edge of the liner can be irritating for a while.

Good Luck
Marcus Boren
Resident

Scott,

I have had the most success cutting the liner pretty much straight across,
however I usually leave it about an inch long so that it folds over a little
at the top. This creates a radius for improved comfort in the perineum. I
have seen many AK trims angled up the lateral side (to try to match the
socket) but I have found that the lateral extension serves virtually no
purpose and can be confusing for the patient. I have been using locking
liners on AKs for 10 years.

Best Regards,
Jim Price, MEd, CPO

Scott, the answer to your question lies in the tissue densities you are
dealing with. If they are fleshy you may need to trim it an angle increasing
height as you go lateral. If you have someone muscular you can trim it lower
and straight across.

I had one lady I trimmed so the liner was proximal to the medial socket brim
and laterally to the head of the trochanter.

Also, I have not had luck using a pin on a Transfemoral patient. Instead I
use a double thickness one inch Velcro strap with a chafe attached on the
socket proximal anterior. I have a distal hole cut through the socket distal
anterior slightly larger than the strap for easy passage. I extend my sockets
on average one inch to allow for distal draw leading to increased suspension.

Finally, I prefer the Iceross comfort tapered suspension sleeves, the average
size I use is a 38CM

If you have questions feel free to e-mail me.

Joe Perry

We cut Alpha liners about an inch above the trim lines all the way around.
But you might want to go a bit higher and let them wear it for a while in
case the liner expands and shrinks lengthwise. We do, however, have
trouble with the liners breaking down proximal medial. Folding the liner
over the trim lines causes breakdown, at least in the Alphas, but it is hard
to get away from this at the medial wall.
I would like to know what others say!
Thanks.

Scott:

Those AK liners I have had success with have been cut straight around but
usually about 2 below the perineum. If your socket is formed or laminated
over a facsimile of the liner then the liner will rests neatly in place. In
some cases a sheath over the liner extending over the socket trim lines was
necessary. If you have trouble achieving proximal suspension, with the
sheath, simply wet the sheath before applying. I often thought of trying to
find a source that would manufacture a custom liner (probably need at least
2) with the upper most portion of the liner of a gentle fabric material.

Best of Luck

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