Saturday, November 26, 2022

Responses to Iceross liner slippage

dEntremont, Andre RQHR

Thank-you very much to all who replied to my post ‘Iceross liner slippage’. Here is compilation of the responses:

A tip from a (British) TF prosthetic user is to use “Impact Sports Grip”, a product intended to to be applied on rugby players’ hands for increased friction/ball control. He applies it prior to running or other physical activities and it has made a big difference for him. Other people who have tried it have reported varying benefit. I imagine there are similar products where you practice. Needless to say, the usual advice regarding risk of skin reactions etc apply.

Is a conical shaped liner needed? Also could try a liner liner. I’m not convinced they lessen perspiration, but atleast the person can easily remove the wet one and reapply a dry one.
Try a Knit Rite Liner Liner Sock. Cheap and simple. Might help.
I have had patients with similar problems of excessive perspiration and normally the issue will resolve itself over a period of 1 to 2 weeks. In those cases where it hasn’t, I have had good results with Certain Dri, an antiperspirant. Certain Dri is to be applied in the evening and not prior to donning the liner in the morning. I have also had patients use an anti-perspirant spray from the ALPS company. The stock number of the ALPS spray is ATP-008.
We have been using liner liner socks under the Silicone as perspiration is a problem in Arizona. It has decreased the slippage issue.
I had a similar exerience recently, but I thought the problem was mainly due to the excess of mineral oil on the liner, as it comes out of the package. Although I wiped off what I considered “excess” with paper towel, it still was very slippery. But my client washed the liner at home and still had the problem of the liner slipping down, causing some blisters according to him.
I solved the problem putting him into a Comfort Liner 2 sizes up, because I figured that apart from the oily slippery surface, the sizing was another problem. His distal measurement ( at 4cm) was 29cm, so I used a 28cm liner according to the instructions. But he has a very conical shape and more proximally the liner was pretty tight, which probably added to the problem. I´m not sure which of these two factors (slippery surface or tightness proximally) contributed the most.
Hope this can be helpful.
The one time I was having real trouble with slippage it turned out the amputee was applying hand lotion to the limb each morning. You might just want to be certain that this is not the case here.
For my heavier “perspirers”, I recommend they buy a clinical strength antiperspirant (like Degree) with 20% Aluminum Zirconium Hexahydrate Glycine-anhydrous, and put it on at night before they go to bed so it is well absorbed by morning. I also have them wear liner-liner socks. I have a young fire fighter who has flown out to Alberta to help in Slave Lake recently and he’s always in the bush here helping out, and he says he still sweats but it’s been cut in half, subjectively stated.
I thought the common accepted rule was that perspiration will diminish once they get used to the liner.
I guess that did not happen. Have you tried a liner/liner, or any other material interface? A patients size after they don the liner is going to be smaller even after 30 min. Is this patient a new amputee with a mature limb? Ask the patient to wear a compression limb sock for one week at night and see if there is a noticeable difference when they put their liner on. Is the liner now too big in the A.M. when they apply it? I do believe most OandP people are impatient with giving good directions or providing written instructions on all levels of understanding how a patient should use and manage their limb activity with their activities. Has you patient been told they retain water and refuse to consistently take their medication (Lasix for instance) to lessen this problem?
You have to be a Sherlock Holmes, but having a relationship for a lifetime with this patient population is worth the work.
I see that occasionally as well. Generally I see the liner that is stretched with us or is slightly oversized. I see you say the liner is the correct size and I have no reason to doubt you. Try either the next size smaller, a replacement of the same size or try a Liner-Liner sock from Knit-Rite, they are designed for just this application especially during hot summer weather. Good luck
Even thought it might seem to be the right liner size, I would possibly try one size smaller. If the limb is conical then sometimes it is hard to guage the perfect size. Also you can get “Certain Dry” over the counter which is similar to Drysol but maybe cheaper.
Have had same problems. Try Alps antiperspirant spray.
Again, thank-you list members.
Andy d’Entremont C.P.(c)


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