Skin Graft Responses

Skin Graft Responses

Metro Health Shop

1/3/2012

Here are the responses for the adherenting skin graft on a Below Knee
Amputations . Thanks to all the people who responded

 George Barefoot C.P.(c)

 

 

Based on your description of the residuum, I suggest using a custom silicone
liner with a custom silicone fill for the valley and then fabricate a total
contact socket with either vacuum,kiss or pin system. This should give you
the protection of the graft and the socket that the patient can weight bear
while distributing the pressure evenly.
Carey Glass CPO FAAOP

 

I would use a custom Harmony Urethane liner with a Vacuum system. I have a
gentleman that has a short transtibial amputation with 75% of this limb
covered with skin grafts and adhesions that previously used a cushion gel
suction socket and later a gel pin system. Even with the gel systems (OWW
Alpha liners) he still experienced break down and pain. I put him in an Otto
Bock custom urethane liner and used the Harmony Vacuum system and he has not
stopped thanking me. He is an avid golfer and golfs 3-4 times a week and has
golfed 36 holes in one day without pain or breakdown. He has a difficult
limb to fit but when I followed OB guidelines to a T it was quick and
painless experience for the patient. He has been in the system for two years
now and continues to praise this system.

 

Rick Stapleton, CPO

 

 

We have a similar case with 2x2.5 adherent scar tissue at anterior distal
tib. We have relived the pressure point by thinning socket wall, thinning
tri-lam insert, having him wear silo-sheath gel sock and adding padding in a
donut shape around the area. Our patient continues to get skin breakdown at
the adhered skin graft. After 6 months of trying everything we can think
of, he is planning to have a revision surgery so he can move on and become
more active.

 

I know it's not much help, but the silo-sheath with nylon inside and outside
seemed to be the most beneficial to our patient.

Kirstin Faircloth

 

 

Otto Bock custom Urethane liner. Lubricate residual limb with Sensicare
lotion. Sleeve suspension, suction socket.

 

Greg Straub, CPO

 

A slip socket that is suspended to the residual limb and fits into an outer
socket with joint and corset with possible ischial support. Never done one
but have seen an old prosthesis made in Germany.

Brian Kaluf