Proper and consistent residual limb skin care and hygiene is an often overlooked but absolutely essential habit to form in order to maintain your health, both in your residual limb and your entire body, as well as to continue utilizing your prosthesis on a daily basis. Without consistent and effective skin care and hygiene, you risk being unable to use your prosthesis, excessive and unnecessary pain and discomfort, and most importantly more serious harm such as infections that can be life-threatening or result in further amputation. Many individuals with amputation strive to regain their independence and mobility, and proper skin care is required to do so on a long-term basis.
The first step in effective skin care and hygiene is to simply reinforce the habit of checking your skin often. Check at least once but ideally twice per day, in the morning and at night. Your residual limb, liner, and socks should be washed daily. Wash your residual limb gently each day with warm water and mild soap to avoid irritation, then pat your limb to dry. Similarly, your socket should be cleaned daily with a clean, damp cloth and dried. Ensure that your limb, liner, sock, and socket are fully dry before redonning.
Skin and wound care is especially important in approximately the first eight weeks following your amputation; during this time, your wound is likely still healing and is more susceptible to irritation and infection. Establishing good hygiene and skin care habits during this time when it is most needed is essential to maintaining these habits and ensuring you will not have issues with your limb and prosthesis in the future.
Along with skin and wound care in the weeks after your amputation, you should also begin to massage your residual limb. Your physician will decide when you are ready to do so, but most individuals are able to begin lightly massaging within a couple days after their amputation. Proper massaging consists of gently rubbing, kneading, tapping, and slapping your limb; doing so helps to toughen the limb and skin, preparing it for daily prosthetic use. Once your wound has fully healed, you may begin massaging harder in order to break up scar tissue within your limb. To start, massage your limb three to four times per day for five minutes. As your limb heals, you can massage it for longer or more frequently as needed. Remember that your limb can be massaged through your dressings, bandage, or shrinker.
We have discussed the importance of checking your skin daily, so let's now discuss what you should be looking for. The most common issues are irritation, dryness, redness, and blisters. Pay special attention to bony areas, the back of your limb, and creases on your limb. Ensure that you check your skin at least once daily, especially after removing your dressings or wearing your prosthesis. In order to avoid irritation, refrain from shaving or applying lotion to your residual limb until your wounds are fully healed. If you experience any of these issues, especially after wearing your prosthesis, contact your prosthetist immediately for an appointment and cease use of your device. Contact your physician as well, and avoid popping blisters or picking at scabs. If you have a wound that is excessively swollen, warm, yellow, has red streaks, or is secreting or contains pus or milky fluid, you may have an infection and should contact your physician immediately.
It is important to remember that your limb is unique, and because of this your journey is and will be unique. Your healing process may be slower, faster, or the same as others. Your limb may have more or less tissue, loose skin, or susceptibility to damage than others. Remind yourself of the importance of caring for your residual limb in order to thrive with your prosthesis and to continue to reach new milestones in your journey.
Pictured below are relatively mild examples of residual lower limb skin problems, including redness, corns, pimples and blisters, and scrapes. Again, while they may not look it, the pictured issues are relatively tame, but still warrant an appointment with your prosthetist or physician. If you see any issues resembling the pictured or especially if you have issues that are more severe than those pictured, contact both your physician and prosthetist immediately.
