To address racial disparities seen in patients of color within O&P, we are developing an evidence-based, digital handbook that will include images and descriptions of various skin problems related to O&P as they appear on black and brown skin. The purpose of the handbook is to improve the skin assessment skills of O&P clinicians, promote equitable care, and produce an educational resource more representative of the population we serve. Prosthesis and orthosis users frequently develop skin problems; scientific literature suggests that up to 75 percent of lower-limb prosthesis users eventually develop a skin problem.1 Because skin evaluations are such a fundamental component of how prosthetists and orthotists assess socket fit, orthosis fit, residual limbs, and wound healing, the omission of black and brown skin tones in educational materials likely contributes to disparities in patient outcomes.
It is well established that racial disparities within the United States healthcare system negatively affect the health and well-being of nonwhite individuals due to implicit and explicit biases, institutional structures, and interpersonal relationships.2 This holds true regarding treatment outcomes for people with black and brown skin who experience skin problems. Dermatological conditions are often misdiagnosed, have a more advanced presentation at the time of diagnosis, or go unnoticed in people with black and brown skin.3 Black patients, in particular, have a significantly higher incidence of pressure injuries, later-stage pressure injuries, and major leg amputation following a diabetic foot ulcer compared to white patients.4,5
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