Skin Disorders

Skin disorders affecting amputees

Skin, as the first point of contact with the socket of an artificial limb, needs to be healthy to enable amputees to be as active as possible without experiencing pain or discomfort – so prevention of skin disorders is a very important consideration.

The following are some problems that may result from these factors:

• Rashes and Abrasions – these are the most common skin disorder which may occur intermittently or even frequently thoughout the amputee’s life time.
• Oedema – characterized by skin swelling, drying and roughening at the end of the stump, and a red-brown pigmentation, this can usually be prevented by gradual compression using an elastic bandage. Although this may seem like a minor affliction at first, it can develop into a serious complication – a doctor should always be consulted.
  
• Contact Dermatitis – this is caused by an irritant, whether in the materials of the socket, or from an outside source, such as a cleaning agent, powder, lubricant or ointment used in amputee care. Once the cause is discovered and treated, the problem usually disappears.
  
• Cysts – these can occurs after a limb has been worn for months or even years. They commonly plague above-knee amputees, occurring on the inside of the leg along the upper edge of the artificial limb, but below-knee amputees can experience them as well. They start as small bumps, or nodules which vanish when the artificial limb is temporarily removed, but the constant rubbing of the artificial limb can make the problem worse as cysts become larger and more numerous. Cysts should always be treated by a doctor, as they can become infected and cause further damage.
  
• Folliculitis – a bacterial infection of the hair follicle which produces small, itching, solid areas. If left untreated, these may later develop into boils in which deep-red, painful nodules rise to the surface of the skin. Anti-bacterial soaps may cut down on the bacteria which cause these conditions. Experienced amputees recommend not shaving the residual limb.
  
• Fungal Infections – another product of the moist, warm conditions in the socket of an artificial limb, these require special creams or powders, which can eventually clear up the condition.
  
• Eczema – this is found in dry, scaly skin which becomes moist for no discernable reason. A cause needs to be established or the condition will recur. Allergies, or secondary conditions following edema can contribute to the condition.
  
• Adherent scars – when there has been repeated infection or ulceration damage to the skin, scar formation may be so intense that scar tissue may become attached to the underlying layers of skin. Surgical revision to free the scar is often necessary.
  
• Ulcers – these sores come from bacterial infections, or from circulation problems. They may become chronic if not diagnosed and treated immediately.