The Amputee Survival Kit
How do amputees cope with this
dilemma? Most of us utilize some type of survival kit. This article will
describe some of the items that amputees have found useful when their residual
limb has problems. This information is based on my personal experience as an
amputee (since 1974) and having been a Certified Prosthetist for fifteen years.
First we must keep the skin clean.
Soap and water work great on a daily basis for most of the body. However,
you've got a part of your body in what is essentially a Petri dish, growing
bacteria. Even if you utilize an antibacterial soap, within a short time most
of the bacteria has regrown. Products that kill lots of bacteria are rubbing
alcohol, Phisoderm, Hibiclens, and Betadine. These are all over-the-counter
cleansers. Alcohol will dry your skin out, so be cautious using it. The other
antibacterial soaps kill most of the bacteria yet provide little long lasting antibacterial
protection. A former disabled ski team member, named George Lombard, introduced
me to Phisohex. It is a prescription item and must be prescribed by your
physician. The difference with Phisohex is that it contains hexachlorophene,
which inhibits the growth of bacteria over a long period of time. This means
hours after you have washed you still have a low bacteria count, greatly
reducing the possibility of irritation or infection. Any skin rash or itch
should be a signal to discontinue use of whatever you utilize to clean your
skin. Take particular care to dry out any skin folds, dimples, or any place
that can trap moisture.
Skin protection materials are a
topic I've lectured on for years. When I lost my leg twenty-two years ago, the
only product available was Ampubalm, a salve with lots of lanolin and mutton
tallow (Yuk) the stuff smelled awful but did provide some friction relief. Then
came Ampaid; which smelled better and had a similar effect as Ampubalm. Bagbalm
is a lubricant utilized in the dairy industry (use your imagination) and also
provides a friction reduction element that can soothe the skin. One of the most
common errors that amputees make on skin care is the use of band-aids or gauze
bandages on abrasions. Often time’s abrasions are created by excessive pressure
on a limited skin surface area. Bandages only increase the pressure and can
actually do more damage than good. Also the adhesive on bandages can damage
delicate or healing skin when removed.
Over thirteen years ago, I became
acquainted with Second Skin, a Spenco product. Second Skin is a thin (1/16
inch) piece of perforated silicone gel. It applies directly to the skin and
adheres by its own viscosity. It totally eliminates skin friction, allows the
skin to breathe, and can actually promote healing. It can be utilized for prevention
or if an abrasion or blister appears. It is expensive and can only be used
once, but for anyone who has had to endure days of pain because of a simple
abrasion, it is worth it.
Second Skin does not work well on
above knee suction sockets unless held in place with their adhesive strips.
There are some products that will work; Bioclusive, Tegaderm, Op-Site, and
Acuderm are the ones I am familiar with. These products provide a thin,
adherent membrane that prevents friction and allows the skin to breathe. The
product can be left on for several days and it is best removed under water. Be
careful not to leave it on for too long as it prevents the skin from sloughing
off and should be replaced every 2-3 days.
For all amputees who wear some type
of sock there is a simple way to make temporary socket adjustments. A small
hole cut into the sock will provide temporary relief to skin that has been
damaged by either an abrasion or a pimple, especially when there is associated
tissue swelling. This works best with a five ply sock, (the thinner the sock,
the less relief), and the trick is to cut as small a hole as possible. Use an
older sock if you have one, and pull onto your residual limb, take a pencil and
draw a circle around the affected area. Remove the sock and cut a hole about
half the size of what you drew. When the sock is put back on, the hole
generally stretches giving plenty of relief. If not, then carefully open up the
hole a little more. Too big of a hole does not provide good relief.
What constitutes a good amputee
survival kit? I am a below knee amputee and my kit consists of: Second Skin, a
tiny pair of scissors (for cutting holes in socks), Hydrocortisone (will
lubricate and kill an itch), duct tape (I have hiked many miles on feet taped
together), a foot bolt wrench and any other Allen wrenches that my let
utilizes. I also carry a washcloth or bandana to wipe perspiration off my
residual limb and my sleeves. When I am engaged in heavy activities where I
perspire a lot, I sometimes have to wipe my suspension sleeve about every half
hour. I carry my kit in a fanny pack with a water bottle.
Above knee amputees will use
slightly different materials in their kits, depending on whether they utilize
suction or a sock. Tegaderm or one of the other adherent membranes may be
substituted for Second Skin. An excellent lubricant for when your skin rubs
against any surface is Vaseline. Since it does not absorb into the skin, it
provides friction relief for hours. Make sure you use it sparingly. For suction
socket wearers who will be engaging in activities that could cause a lot of
perspiration, I recommend some auxiliary means of suspension. A removable Silesian
belt is an excellent addition to any above knee suction socket but it needs to
be built into the prosthesis. There are neoprene suspension belts that give
great freedom of motion that can be obtained through your prosthetist.
Upper extremity amputees rarely
experience the friction and pressures of ones body weight on a prosthesis.
However, under heavy loading, or over delicate skin, pressure and friction can
occur. A kit including scissors, Second Skin, and Vaseline can also come in
handy.
Each amputee will find the specific
combination of skin protection materials to create their amputee survival kit
tailored for them personally. Residual limbs change under pressure, over time,
especially under increased activity. If you are an amputee and you don't have
some type of survival kit then it's like driving around without a spare tire
for your car.
• 1 small pair of scissors
• Bioclusive,
Tegaderm, Op-Site, or Acuderm (for abrasions or blisters, 3-5 units depending
on time away)
• Hydrocortisone for itch and
lubrication
• Talc, Zeasorb, Baby powder or another
sweat absorbent (for help f or
putting your Prosthesis on)
• A small towel, to dry your stump for
sweat
• If you're
on a trip then I would take Phisohex, Hibiclens, or one of the other strong
Antibacterial soaps to keep your stump clean
• Waterless
hand cleanser, handy wipes, alcohol preps or something similar (to keep the
stump and socket clean)
• Extra stump socks and sheaths
• A stocking
net and valve tool (to help you get your suction socket on after you've
repaired your body parts or prosthesis)
• A Foot Bolt
and wrench plus all of the Allen wrenches (for your prosthesis for adjustments
and repair)
• Duct tape
(for temp repairs, like if your frame, foot, or socket needs temp help -
smallest roll you can find)
• Thin cell
foam (to help alleviate pressure points on your weights bearing areas)
• Lubriderm or some other Medicated
cream (for dryness)
• Stump shrinkers
(if you have to take it off to repair then you want to be able to get it back
on)
• Topical
antibiotic (for minor sores or popped pimples then cover them with Tegaderm)
• 5-10 Pain killers (depending how long
you will be away from home)
This
is just a basic travel kit you can be as elaborate or delete things that don't
apply to your situation. You should try to get all of your creams, powders,
Duct tape, and cleansing agents in the smallest possible sizes so that you can
have them with you at all times. It goes without saying that you should carry
all of your necessary medications with you when you will be away from home for
any period of time.
For
More Information call Rick Riley at 775-830-1783
Email
[email protected]
Visit
my website at prostheticconsulting.com
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