I am experiencing intermittant proximal medial tissue break down on one of my
young active Transtibial amputees. His current Rx includes silicone liner
with IPOS silicone suction sleeve. The problem occurs in the proximal medial
sleeve suspension region and generally occurs with a new sleeve which is replaced
on a frequent basis. The area begins proximally and works its way distally and
ends up approximately three by five inches.Hygiene has not been an issue thus
far.
We have tried other suspension sleeves with similar results, we have tried
lotions, hydrocortosone creams and other topicial agents under the supervision
of a dermatologist. The only thing that cures this is a round of antibiotics
which shows improvement within a few days.
I instructed him to try and place a prestretch on the liner prior to use as
he has a well developed medial adductor compartment. My thoughts are we have a
minor abrasion that turns into cellulitis which in turn is exarcerbated by
heat, perspiration and bacteria. The liner and sleeve are washed at least once
per day. Different soaps have been tried, but again, the problem is not
predictable with activity, diet, or time. Thus far the problem has occured five times
this year.
Any thoughts???
Joe Perry CP, RFO
