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Prosthetics
The inside of the prosthetic socket and the skin clean is important to prevent illnesses or infection. Wash your limb daily with warm water and a mild, fragrance free soap. Fragrance free soap is important as any fragrance on the skin can cause irritation or a reaction when your limb is enclosed in the prosthetic socket. The inside of the socket or the liner should be cleansed daily, wiping with warm water and a soapy, fragrance free cloth. There are also several products and options available to toughen the skin, helping to make the use of prosthetic devices more comfortable; lotions, ointments, tapes and bandages, and glue like liquids are all available at your request.
AK (Above Knee) Amputees
Swelling in a residual limb can occur after surgery, while getting used to a new prosthetic, or for a number of other reasons. Using a compression wrap, also known as a shrinker sock, will help compress the muscle and tissue at the area of swelling and return it to normal over time. These are designed to apply the greatest amount of pressure at the bottom of a limb, gradually reducing swelling and shaping the limb’s lower end. The compression wrap is a sock like piece of fabric with an elastic band at the upper end, sized to fit your residual limb. It is important to check the wrap three to four times a day to ensure that it is in the correct place; excess room at the bottom of the sock will allow the limb to swell into that space. Ultimately, each patient is unique when it comes to swelling and how their body will react to surgery and prosthetics, and a patient’s age and overall health are factors that affect how long it will take for swelling to reduce.
BK (Below Knee) Amputees
For below knew amputations, several dressings and devices are used to reduce swelling and protect the amputated area. Immediately following surgery, an Immediate Post-Operative Prosthesis (IPOP) can be used on the residual limb to prevent excessive swelling, knee flexion contractures (i.e. the knee locking in place caused by the leg being bent in one position for a long period of time), and protects it from bumps and further injury. The IPOP is a cast that extends above the knee and is worn for the first two weeks following surgery. A lightweight pylon may be used to attach an artificial foot to the cast, allowing for limited mobility.
When the IPOP is removed, a Removable Rigid Dressing (RRD) is applied to extend the knee and prevent further injuries. The RRD is another type of cast that can be removed daily in order to inspect and clean the limb. As the swelling of the residual limb continues to decline, compression wraps can be worn underneath to ease comfort and swelling issues.
Prosthesis Care Dos and Don’ts
Do’s and Don’ts
DO participate in physical therapy
DO control swelling
DO exercise
DO keep your residual limb clean
DO keep your residual limb straight (BK amputees)
DON’T place a pillow under your back, curving your spine
DON’T place a pillow under your hip or knee
DON’T place a pillow between your thighs
DON’T hang residual limb over the edge of the bed or sit in a chair with the limb bent for an extended period of time
DON’T lay with knees bent
DON’T sit with legs crossed
DON’T rest residual limb on crutch handle
Orthotics
When wearing an orthosis it is very important to maintain proper hygiene and to be mindful of your skin and area around your device. Watch for any redness, blisters, sores, or abrasions, and if reactions occur and do not withdraw within 30 minutes of removing your device, call your orthotist and arrange for an appointment. To prevent skin damage caused by an orthotic device, make sure it is applied as snugly as possible to keep from rubbing against your skin. If you are wearing a back or spinal orthosis, a seamless t-shirt or tank top might increase your comfort. In any case, remember, some skin irritation and soreness is normal as your body and skin become accustomed to your new device.
Before you apply your orthosis, be sure that your skin and the orthosis are both clean and completely dry. Be sure to bathe daily and to keep your skin clean, and if you perspire be sure to attend to it regularly; perspiration can cause a build up of bacteria, leading to odor and possible infection.
Taking proper care of your orthotic device is essential to your recovery and your success as an orthotic patient. Each orthotic device will have special care instructions, which your orthotist will provide for you and help you answer, but each device should be properly, cleaned, maintained, and upheld. Most orthotics can be cleaned with a diluted alcohol mixture and water, and be sure that your device is completely dry before wear and use. Before application, check the orthotic’s straps, joints, hinges, snaps, and fasters to ensure that they are in proper working condition. If they become worn or broken, contact your orthotist; replacements may be available.
Other
Diabetic Foot Care Program
The Diabetic Foot Care Program is part of an integrated rehabilitation process committed to your health, walking ability, independence, and overall quality of life. By developing a relationship with your orthotist / pedorthist and maintaining a healthy lifestyle, we can help keep you mobile and active. See the steps we take with you to keep you going!
Personal Hygiene and Skin Care
Here, cleanliness is the key. Practice good hygiene habits by cleansing and inspecting your feet and wearing clean socks each day.
Orthoses
Diabetic insoles and arch supports MUST be custom made and fully contoured to the plantar surface of your foot.
Know Your Feet
Your feet are your best friend, and daily inspection is required to keep them as fit as possible. Look for blisters, sores, cracks, cuts, calluses, corns, etc. at the top, bottom and sides with a mirror, making sure to report any changes to your physician or orthotist/pedorthist immediately.
Cleaning and Softening
Wash daily with mild soap and lukewarm water and dry thoroughly. Apply cream or lotion on tops and bottoms only, not between toes. Wear clean socks each day.
Toenail Care
It is best to trim right after your shower or bath. If you have a neuropathy, poor vision and/or extremely thick toenails—STOP—and enlist the care of a podiatrist!
Over-the-Counter Remedies
When dealing with foot related issues like warts and callouses, it is crucial that you do so the correct way. DO NOT use corn or wart removers. DO NOT remove corn or calluses with a razor blade. DO NOT warm up cold feet with a heating pad or hot water bottle. ALWAYS check with your doctor first.
Footwear
When trying to stay healthy, avoid any unnecessary risks when possible. NEVER walk barefoot and ALWAYS wear shoes and socks. Examine shoes for signs of wear. Wear the proper footwear—your long-term health and mobility is more important than fashion.
Diabetic Foot Care Dos and Don’ts
DO
DO watch your blood sugar!
DO eat nutritious foods!
DO inspect your feet daily!
DO participate in an exercise program!
DO communicate!
DON’T
DON’T smoke!
DON’T drink excessive alcohol!
DON’T sit or lay with crossed legs or ankles!
DON’T wear sandals with thongs!
DON’T use adhesive tape!
DON’T soak your feet!
