Ossur seal-in replies
Van Lenthe, Brad
Description
Collection
Title:
Ossur seal-in replies
Creator:
Van Lenthe, Brad
Date:
3/16/2006
Text:
Thanks to all for your feedback on my original post which is as follows:
I have a client (middle aged male, moderately active, no other skin issues)
who is new to seal-in liners, but not to Ossur liners. He was getting some
distal end irritation from the pin draw so we switched to dermo seal-in
liners.
We just produced a new socket and test socket showed good contact
everywhere. After fabrication and dispensing he went to Israel for a
vacation - lots of walking, He developed a blister on tibial crest right
where the seal-in bladder is. He reports to feel like the bladder is
bunching up (no apparent loss of suspension associated - although he did
report loss of suspension a few times while sitting) - any ideas?
I have not had opportunity to try anything yet, but the suggestions have given me some options.
-Brad van Lenthe C.P.(c)
Replies:
Did he flatten the rubber memberane before donning the socket - maybe it's
rolling up under itself? This seems to reduce the seal with the socket in
my experience.
Jacqueline Schmit, MS, CP
Certified Prosthetist
-----------------------------------------------------------------------------------------
Use a flexible interface like 1/8 proflex inside the socket and do a plaster buildup over it before you laminate. This will allow it to flex enough to relieve pressure, but it won't stretch to break suspension. A flexible inner liner also opens you up to more valve options, such as adjustable leak rate valves which I have found to be beneficial to folks new to the seal-in system or any other sort of suction suspension. Once they are used to it you can eliminate the leak all together. Also, try Vitamin A&D Ointment without Zinc on the problem locations before donning the liner. This allows the skin to freely move under areas of pressure and tension, which makes for a more comfortable socket. I don't care for the Equate brand because it's too thin and migrates inside the liner once the patient begins to sweat.
Thank you very much,
Matthew C. Daniels, CP
--------------------------------------------------------------------------------------------------------
Having fit many seal-in systems here is a question. Sorry for the obvious,
the pt. is fully reflecting liner? Next, what is the limb length; I have
found the seal-in system works better for slightly longer transtibial
patients. You have to fit the liner tighter than one would normally fit the
Ossur liners, this will allow for good seal tension, but not a tight fit.
If the pt was in a pin system he may be having some change in limb shape
with the new system that could be leading shape change. I have found I make
the seal-in systems tighter than normal for good control. I often use an
alcohol spray or waterless hand cleaner as a lubricant. You may consider
the use of a thin vivak liner laminated inside the socket to control air
leaks. Other than some other standard points of interest this is someof my
findings. Hope it helps!
W. Robert Devlin, CPO
-----------------------------------------------------------------------------------
It sounds as if his liner might be too big. Carefully read the instructions
that came with the liner and call Ossur. I was surprised to see how tightly
these liners need to fit to have a good seal for suspension.
Good Luck,
Dave A. Janke CPO
Portland, OR
-------------------------------------------------
What I have found out is that the Seal-In liner is sensitive for volume
changes. And if your client has been walking a lot there is a risk for a
volume change that makes by the seal move more. My suggestion is that you
change to Dermo without distal adapter and use a sleeve suspension during
the healing period.
Anton Johannesson, CPO
Secretary ISPO-Sweden
Ortopedteknik AB
291 85 Kristianstad
Sweden
Tel: +46 (0) 708 11 12 93
E-post: <Email Address Redacted>
---------------------------------------------
If you find out please share with me. I have fit several AK's no BK's and
found that pt. did loose suction while sitting. The only thing I found that
work to prevent this was to make the fit tighter. Some by placing pads
between the frame and flexible socket. Others by adding a sock under the
seal. Yes, Ossur makes a sock for this purpose. Blisters are caused by
movement between the skin and the interface. Maybe the high activity caused
volume loss, then perspiration which allowed movement. Hence Blister
developed. Just a thought!
Good luck!
Looking forward to your response.
Erik Tompkins,CP,BOCPO
********************
To unsubscribe, send a message to: <Email Address Redacted> with
the words UNSUB OANDP-L in the body of the
message.
If you have a problem unsubscribing,or have other
questions, send e-mail to the moderator
Paul E. Prusakowski,CPO at <Email Address Redacted>
OANDP-L is a forum for the discussion of topics
related to Orthotics and Prosthetics.
Public commercial postings are forbidden. Responses to inquiries
should not be sent to the entire oandp-l list. Professional credentials
or affiliations should be used in all communications.
I have a client (middle aged male, moderately active, no other skin issues)
who is new to seal-in liners, but not to Ossur liners. He was getting some
distal end irritation from the pin draw so we switched to dermo seal-in
liners.
We just produced a new socket and test socket showed good contact
everywhere. After fabrication and dispensing he went to Israel for a
vacation - lots of walking, He developed a blister on tibial crest right
where the seal-in bladder is. He reports to feel like the bladder is
bunching up (no apparent loss of suspension associated - although he did
report loss of suspension a few times while sitting) - any ideas?
I have not had opportunity to try anything yet, but the suggestions have given me some options.
-Brad van Lenthe C.P.(c)
Replies:
Did he flatten the rubber memberane before donning the socket - maybe it's
rolling up under itself? This seems to reduce the seal with the socket in
my experience.
Jacqueline Schmit, MS, CP
Certified Prosthetist
-----------------------------------------------------------------------------------------
Use a flexible interface like 1/8 proflex inside the socket and do a plaster buildup over it before you laminate. This will allow it to flex enough to relieve pressure, but it won't stretch to break suspension. A flexible inner liner also opens you up to more valve options, such as adjustable leak rate valves which I have found to be beneficial to folks new to the seal-in system or any other sort of suction suspension. Once they are used to it you can eliminate the leak all together. Also, try Vitamin A&D Ointment without Zinc on the problem locations before donning the liner. This allows the skin to freely move under areas of pressure and tension, which makes for a more comfortable socket. I don't care for the Equate brand because it's too thin and migrates inside the liner once the patient begins to sweat.
Thank you very much,
Matthew C. Daniels, CP
--------------------------------------------------------------------------------------------------------
Having fit many seal-in systems here is a question. Sorry for the obvious,
the pt. is fully reflecting liner? Next, what is the limb length; I have
found the seal-in system works better for slightly longer transtibial
patients. You have to fit the liner tighter than one would normally fit the
Ossur liners, this will allow for good seal tension, but not a tight fit.
If the pt was in a pin system he may be having some change in limb shape
with the new system that could be leading shape change. I have found I make
the seal-in systems tighter than normal for good control. I often use an
alcohol spray or waterless hand cleaner as a lubricant. You may consider
the use of a thin vivak liner laminated inside the socket to control air
leaks. Other than some other standard points of interest this is someof my
findings. Hope it helps!
W. Robert Devlin, CPO
-----------------------------------------------------------------------------------
It sounds as if his liner might be too big. Carefully read the instructions
that came with the liner and call Ossur. I was surprised to see how tightly
these liners need to fit to have a good seal for suspension.
Good Luck,
Dave A. Janke CPO
Portland, OR
-------------------------------------------------
What I have found out is that the Seal-In liner is sensitive for volume
changes. And if your client has been walking a lot there is a risk for a
volume change that makes by the seal move more. My suggestion is that you
change to Dermo without distal adapter and use a sleeve suspension during
the healing period.
Anton Johannesson, CPO
Secretary ISPO-Sweden
Ortopedteknik AB
291 85 Kristianstad
Sweden
Tel: +46 (0) 708 11 12 93
E-post: <Email Address Redacted>
---------------------------------------------
If you find out please share with me. I have fit several AK's no BK's and
found that pt. did loose suction while sitting. The only thing I found that
work to prevent this was to make the fit tighter. Some by placing pads
between the frame and flexible socket. Others by adding a sock under the
seal. Yes, Ossur makes a sock for this purpose. Blisters are caused by
movement between the skin and the interface. Maybe the high activity caused
volume loss, then perspiration which allowed movement. Hence Blister
developed. Just a thought!
Good luck!
Looking forward to your response.
Erik Tompkins,CP,BOCPO
********************
To unsubscribe, send a message to: <Email Address Redacted> with
the words UNSUB OANDP-L in the body of the
message.
If you have a problem unsubscribing,or have other
questions, send e-mail to the moderator
Paul E. Prusakowski,CPO at <Email Address Redacted>
OANDP-L is a forum for the discussion of topics
related to Orthotics and Prosthetics.
Public commercial postings are forbidden. Responses to inquiries
should not be sent to the entire oandp-l list. Professional credentials
or affiliations should be used in all communications.
Citation
Van Lenthe, Brad, “Ossur seal-in replies,” Digital Resource Foundation for Orthotics and Prosthetics, accessed November 25, 2024, https://library.drfop.org/items/show/226387.
