responses to custom liners

responses to custom liners

Skewes, Ed

3/11/2005

Thank you to all that responded to a question about custom liners, here are
some comments I received,
   Sincerely,
  Ed Skewes


I would generally consider a custom TEC for the kind of problem you
describe. The reason, I believe, that it works well for the residual limb
with scarring, grafted skin and adhesions is that the Urethane liner is
designed to be used with a non-disappearing lotion and to flow around the
skin, preventing skin traction problems. I would definitely not use a pin
locking system, but a sealing sleeve and valve or even the Harmony or other
vacuum assisted suction system. If you don't have experience with the TEC,
there can be a LARGE learning curve. My advice would be to really
understand how the system works, attend one of their courses if you haven't
and update yourself if you have, before attempting to use it. Evaluating,
obtaining and maintaining an optimal socket fit with these liners is
critical. This is complicated by the fact that the residual limbs tend to
change shape and shrink dramatically with the Total Surface Bearing of the
TEC, at least this has been my experience.

I am trying one of the new Evolution liners on a young KD but we haven't
even gotten it in yet and his is not nearly as complicated as the case you
describe. I don't know enough about that liner to know if it might work for
a case like this. Good luck and let me know if I can offer any further
advice or assistance.

OWW is now in the process of providing Custom Liners.

Try the Alps easy liners, uncovered version in a small size. I think it may

fit the distal end well and flexible enough to not be too tight around the
knee.
It is possible to manufactur your liners either silicone based or urethane
based. There is money to be made in this field too bad I am not able to
capitalize as in back up the know how with money. If you have any doubt
please read attached letter by John Michael. I am the person who started
the making silicone hip disarticulation and hemipelvectomy. Every body has
gotten their few minutes of fame. The pictures you have seen in
Hipdisarticulation and Hemipelvectomy portion of prosthetics atlas belong
to my patients. Hope one day soon I will be in position to back up my mouth
with money and may be provide a service to the patients who need custom
liners.
I have had great success with ALPS Sticky thermoliner, EX. Model STFR-28-6
This is a new product and has
received approval from DMERC for custom liner codes. The gel is wonderful
for scar tissue and if needed,
you can get it non-sticky with impregnated powder for sensitive skin Ex
TFFR-28-6. Combined with a VIVA
sleeve excellent suction can be obtained, I do recommend 6mm sleeve for
increased durability. Just a
thought! This has worked well for me in the past!
San Francisco Prosthetics 415-861-4146
I have been very pleased with the custom silicone liners from Freedom
Innovations.
Best custom liner is evolution s p liners
The guys at Freedom make a really nice durable custom liner called the
Evolution. They can make the liner thicker or thinner anywhere you want.
Attached is literature for the liner.


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