responses to perspiration issues
Brittany White
Description
Collection
Title:
responses to perspiration issues
Creator:
Brittany White
Date:
1/15/2013
Text:
Thanks for all the great responses! I will pass on to my patient and let
you know what works! I tried to condense some, but long response:
Had several recommendations for Certain-dri:
The instructions that it must be applied daily, at bedtime, and used
sparingly must be followed. An Rx is not required as it is available over
the counter.
Certain dri is great but has the same aluminum chloride as drysol only in
smaller amount.
Just a word of caution though: it is aluminum
based so have her try it on a small area of the skin before applying
it to her entire residuum.
I encourage my patients to use Certain Dri antiperspirant at night,
after a bath or shower. In the morning, before donning their suspension
liner or sleeve, I encourage them to put on Adapt Skin 50 over their
entire limb. It's a moisture barrier, to prevent problems associated
with prolonged exposure to moisture.
Adapt skin 90 is used to reduce the coefficient of friction over hot
spots like the distal end, and fibular head.
Adapt skin 50 and 90 are different than ampu-balm. It's a medical grade
lanolin and can be ordered year round. Ampu-balm can turn rancid and
can't be ordered at specific times of the year, for some reason.
---
Get rid of the cotton sock as it absorbs water and try just a nylon under
the liner. Done that with a few people now and it seems to wick the
moisture away a little better
---
Several recommendations for Valor Sock from Swiftwick
They are a sock company and this is their first foray into prosthetics. The
sock is meant to be worn under a liner but it will be different than the
other liner-liners you have tried because it is made of superior moisture
managing compression fabric. It's very purpose is moisture management. I am
using these socks on a very high activity, high sweat bilateral transtibial
and he loves them. Before these he tried the usual liner-liners and he
finds this Valor sock to be far superior.
the contact person, who is an
amputee, is
John Mabry(615-983-6453).
Here is a link: <URL Redacted>
---
Might be worth having the patient see a dermatologist as I've heard Botox
injections sometimes can help.
---
There have been a few chronic excessive perspiration patients of mine whose
problems were largely resolved by using an ALPS Skin Reliever inside their
regular liner, if that has not already been tried. The worst one was a
lady whose liner would slide off on its own 10-15 minutes after donning,
even without donning the prosthesis, due to perspiration essentially
eliminating all friction between her limb and the liner. For her a Liner
Liner made things worse. I don't know what it is about the Skin Reliever
that helps, but for some it made a significant difference.
With the amount of sock your patient is using she should be able to
accommodate it inside her socket without difficulty. It tapers from about
1mm thick at the top to maybe 3mm at the distal end, and they are very
elastic.
One other thing I have found with some patients is that the temptation to
use a slightly smaller liner to help counter the loss of friction can
actually make things worse.
---
Has your patient experimented with not wearing a sock under her liner. I
have been told that any air between the skin and liner physiologically
allows increased perspiration. If she can, she should try no sock under
liner for at least 3-4 weeks. There is another product out there that
stops palms from sweating. There is an anti-hyperhydrosis material I have
in my office. I'm not sure exactly what it is called since I'm in the
road. Dri ? If you are interested let me know and I will check. Good
luck.
---
Few things..... Get her out of ptb and go total contact. Get her out of a
mineral gel liner. Use an elevated vacuum pump ie harmony ( moisture
evacuation system =l5781).
Ptb has areas for heat to build up due to reliefs.
Total contact will not have hotter areas like a ptb
Mineral gel liners with a 10 ply fit would be incredibly hot..... If using
just passive suction I aim for 3 on vascular patients. Use a liner like the
6y512 from OttoBock or even custom to keep the liner fit anatomical where
there can be nowhere for sweat to build up. Note: not a tight liner.
And consider elevated vac because it will actually pull some sweat out if
you obtain a proper fitting socket and use the system according to the
specs....
---
There is a recent article in the O&PO Edge on page 40 and following dealing
with this issue. On a personal note, I am the one advocating the use of
Alum as far back as 1995 and have had a certain degree of success with that.
Not all solutions work for all people as you well know. I feel that we as
prosthetists need to have these 3 items available in our lab, rather than
sending our clients on a wild-goose chase to find them on their own.
---
My co-worker said that his patients have reported less sweating using the
Alps Winter's gel liners. I am about to try it on 1 of my patients.
---
Any chance in getting her to wear a snug fitting liner without the liner
sock
Air seams to invite perspiration
Maybe cause the limb is very warm and has the ability for air to cool the
limb as normal
Can the liner be tolerated if just a little smaller to help shut down the
glands
That's my stab
Give it your best
---
I have heard of an electrolysis system, that with use over time reduced
perspiration. Unfortunately the name of said system evades me, however it
worked with the user placing their a piece of their body in some water
linked by an electrode to another such device, which was then linked up to
a control unit.
This system isn't widely used in uk, but perhaps an option for someone
who's tried most others.
We also commonly advise the use of an antiperspirant called driclor which
is worn at night and rinsed off before using the prosthesis.
Hope it helps point you in the right direction.
---
I have had perspiration issues with the Alps liners due to their inability
to maintain original volume. Trying switching to an Ossur Comfort plus
locking liner. You will find a much improved volume retention and less
pistoning. The other choice is to change her to a vacuum system-which I am
sure you are aware.
---
Other thing maybe the liner is to large allowing to much air exchange
---
I have had good success with using breast-feeding pads to absorb the
moisture. Place this at the distal end of stump, roll on liner and don
leg as per usual. The pad is thin and ultra absorbent and can be
disposed of at the end of the day. I prefer not advising patients to use
anti-perspirants or powders, and have a few patients successfully using
this technique.
---
sounds like a good candidate for elevated vacuum which does not stop the
sweating, but wicks out and away. (the sweat evaporates at a lower temp
under vacuum.)
--
Brittany White CO
BioTech Prosthetics and Orthotics
biotechnc.com
919-471-4994
you know what works! I tried to condense some, but long response:
Had several recommendations for Certain-dri:
The instructions that it must be applied daily, at bedtime, and used
sparingly must be followed. An Rx is not required as it is available over
the counter.
Certain dri is great but has the same aluminum chloride as drysol only in
smaller amount.
Just a word of caution though: it is aluminum
based so have her try it on a small area of the skin before applying
it to her entire residuum.
I encourage my patients to use Certain Dri antiperspirant at night,
after a bath or shower. In the morning, before donning their suspension
liner or sleeve, I encourage them to put on Adapt Skin 50 over their
entire limb. It's a moisture barrier, to prevent problems associated
with prolonged exposure to moisture.
Adapt skin 90 is used to reduce the coefficient of friction over hot
spots like the distal end, and fibular head.
Adapt skin 50 and 90 are different than ampu-balm. It's a medical grade
lanolin and can be ordered year round. Ampu-balm can turn rancid and
can't be ordered at specific times of the year, for some reason.
---
Get rid of the cotton sock as it absorbs water and try just a nylon under
the liner. Done that with a few people now and it seems to wick the
moisture away a little better
---
Several recommendations for Valor Sock from Swiftwick
They are a sock company and this is their first foray into prosthetics. The
sock is meant to be worn under a liner but it will be different than the
other liner-liners you have tried because it is made of superior moisture
managing compression fabric. It's very purpose is moisture management. I am
using these socks on a very high activity, high sweat bilateral transtibial
and he loves them. Before these he tried the usual liner-liners and he
finds this Valor sock to be far superior.
the contact person, who is an
amputee, is
John Mabry(615-983-6453).
Here is a link: <URL Redacted>
---
Might be worth having the patient see a dermatologist as I've heard Botox
injections sometimes can help.
---
There have been a few chronic excessive perspiration patients of mine whose
problems were largely resolved by using an ALPS Skin Reliever inside their
regular liner, if that has not already been tried. The worst one was a
lady whose liner would slide off on its own 10-15 minutes after donning,
even without donning the prosthesis, due to perspiration essentially
eliminating all friction between her limb and the liner. For her a Liner
Liner made things worse. I don't know what it is about the Skin Reliever
that helps, but for some it made a significant difference.
With the amount of sock your patient is using she should be able to
accommodate it inside her socket without difficulty. It tapers from about
1mm thick at the top to maybe 3mm at the distal end, and they are very
elastic.
One other thing I have found with some patients is that the temptation to
use a slightly smaller liner to help counter the loss of friction can
actually make things worse.
---
Has your patient experimented with not wearing a sock under her liner. I
have been told that any air between the skin and liner physiologically
allows increased perspiration. If she can, she should try no sock under
liner for at least 3-4 weeks. There is another product out there that
stops palms from sweating. There is an anti-hyperhydrosis material I have
in my office. I'm not sure exactly what it is called since I'm in the
road. Dri ? If you are interested let me know and I will check. Good
luck.
---
Few things..... Get her out of ptb and go total contact. Get her out of a
mineral gel liner. Use an elevated vacuum pump ie harmony ( moisture
evacuation system =l5781).
Ptb has areas for heat to build up due to reliefs.
Total contact will not have hotter areas like a ptb
Mineral gel liners with a 10 ply fit would be incredibly hot..... If using
just passive suction I aim for 3 on vascular patients. Use a liner like the
6y512 from OttoBock or even custom to keep the liner fit anatomical where
there can be nowhere for sweat to build up. Note: not a tight liner.
And consider elevated vac because it will actually pull some sweat out if
you obtain a proper fitting socket and use the system according to the
specs....
---
There is a recent article in the O&PO Edge on page 40 and following dealing
with this issue. On a personal note, I am the one advocating the use of
Alum as far back as 1995 and have had a certain degree of success with that.
Not all solutions work for all people as you well know. I feel that we as
prosthetists need to have these 3 items available in our lab, rather than
sending our clients on a wild-goose chase to find them on their own.
---
My co-worker said that his patients have reported less sweating using the
Alps Winter's gel liners. I am about to try it on 1 of my patients.
---
Any chance in getting her to wear a snug fitting liner without the liner
sock
Air seams to invite perspiration
Maybe cause the limb is very warm and has the ability for air to cool the
limb as normal
Can the liner be tolerated if just a little smaller to help shut down the
glands
That's my stab
Give it your best
---
I have heard of an electrolysis system, that with use over time reduced
perspiration. Unfortunately the name of said system evades me, however it
worked with the user placing their a piece of their body in some water
linked by an electrode to another such device, which was then linked up to
a control unit.
This system isn't widely used in uk, but perhaps an option for someone
who's tried most others.
We also commonly advise the use of an antiperspirant called driclor which
is worn at night and rinsed off before using the prosthesis.
Hope it helps point you in the right direction.
---
I have had perspiration issues with the Alps liners due to their inability
to maintain original volume. Trying switching to an Ossur Comfort plus
locking liner. You will find a much improved volume retention and less
pistoning. The other choice is to change her to a vacuum system-which I am
sure you are aware.
---
Other thing maybe the liner is to large allowing to much air exchange
---
I have had good success with using breast-feeding pads to absorb the
moisture. Place this at the distal end of stump, roll on liner and don
leg as per usual. The pad is thin and ultra absorbent and can be
disposed of at the end of the day. I prefer not advising patients to use
anti-perspirants or powders, and have a few patients successfully using
this technique.
---
sounds like a good candidate for elevated vacuum which does not stop the
sweating, but wicks out and away. (the sweat evaporates at a lower temp
under vacuum.)
--
Brittany White CO
BioTech Prosthetics and Orthotics
biotechnc.com
919-471-4994
Citation
Brittany White, “responses to perspiration issues,” Digital Resource Foundation for Orthotics and Prosthetics, accessed November 23, 2024, https://library.drfop.org/items/show/234585.
