Responses (part 4) Skin grafts and scars for TT
Randall McFarland, CPO
Description
Collection
Title:
Responses (part 4) Skin grafts and scars for TT
Creator:
Randall McFarland, CPO
Text:
MORE RESPONSES: to the discussion of interfaces.
The response from John Wall has a lot of merit. Bag Balm works wonders on
this
kind of tissue. It also works very well on adhesions under a silicone liner
(I've been using it for the past ten years), but don't try it with an alpha
liner.)
I would imagine that your client is not able to wear a shrinker at the
moment,
but she could get nice compression using a clear-gen liner from ALPS.
My experience has always been that a fairly stiff gel liner with a sock
over it will
allow nearly all of the shear forces to dissipate between the liner and the
sock. For a temporary prosthesis, just a sock should work out pretty well,
but
as she loses volume and increases activity, a liner will help to reduce the
friction on the skin.
Marcus Boren
I have one pt who is a very short TT with adherent scar tissue. He has been
an amputee for approximately 20 years and I have been following him for the
past five years. I do not know if there are any precautionary measures to
prevent the scar tissue from adhering but I can tell you what we have learned
works for him. We have yet to come up with anything flawless, but what works
best is an ischial weight bearing brim with single axis joints, belt
suspension and wool socks for cushioning. We have tried 3s and the pt could
not tolerate the draw on his residual limb. We have tried a silicone liner
over a silicone distal end cap with sock and a bocklite liner, but the pt was
uncomfortable at the point of adherence. Possibly if a silicone liner is
used to protect the scar tissue once the pt is very well healed, it may keep
the tissue mobile and prevent it from adhering.
Kirsten Richards C.P.
The response from John Wall has a lot of merit. Bag Balm works wonders on
this
kind of tissue. It also works very well on adhesions under a silicone liner
(I've been using it for the past ten years), but don't try it with an alpha
liner.)
I would imagine that your client is not able to wear a shrinker at the
moment,
but she could get nice compression using a clear-gen liner from ALPS.
My experience has always been that a fairly stiff gel liner with a sock
over it will
allow nearly all of the shear forces to dissipate between the liner and the
sock. For a temporary prosthesis, just a sock should work out pretty well,
but
as she loses volume and increases activity, a liner will help to reduce the
friction on the skin.
Marcus Boren
I have one pt who is a very short TT with adherent scar tissue. He has been
an amputee for approximately 20 years and I have been following him for the
past five years. I do not know if there are any precautionary measures to
prevent the scar tissue from adhering but I can tell you what we have learned
works for him. We have yet to come up with anything flawless, but what works
best is an ischial weight bearing brim with single axis joints, belt
suspension and wool socks for cushioning. We have tried 3s and the pt could
not tolerate the draw on his residual limb. We have tried a silicone liner
over a silicone distal end cap with sock and a bocklite liner, but the pt was
uncomfortable at the point of adherence. Possibly if a silicone liner is
used to protect the scar tissue once the pt is very well healed, it may keep
the tissue mobile and prevent it from adhering.
Kirsten Richards C.P.
Citation
Randall McFarland, CPO, “Responses (part 4) Skin grafts and scars for TT,” Digital Resource Foundation for Orthotics and Prosthetics, accessed November 7, 2024, https://library.drfop.org/items/show/217169.
