United States Department of Veterans Affairs

Volume 46 Number 9, 2009
Pages 1085 — 1090

Abstract – Skin problems in individuals with lower-limb loss: Literature review and proposed classification system

Kelly M. Bui, MD;1 Gregory J. Raugi, MD, PhD;2-3 Viet Q. Nguyen, MD;1 Gayle E. Reiber, MPH, PhD2,4*

1School of Medicine, University of Washington, Seattle, WA; 2Health Services Research and Development Service, Department of Veterans Affairs (VA) Puget Sound Health Care System, Seattle, WA; 3Primary and Specialty Medical Services, Division of Dermatology, VA Puget Sound Health Care System, Seattle, WA; 4School of Public Health, University of Washington, Seattle, WA

Abstract — Problems with skin integrity can disrupt daily prosthesis use and lead to decreased mobility and function in individuals with lower-limb loss. This study reviewed the literature to examine how skin problems are defined and diagnosed and to identify the prevalence and types of skin problems in individuals with lower-limb loss. We searched the literature for terms related to amputation and skin problems. We identified 777 articles. Of the articles, 90 met criteria for review of research methodology. Four clinical studies met our selection criteria. The prevalence rate of skin problems was 15% to 41%. The most commonly reported skin problems were wounds, abscesses, and blisters. Given the lack of standardized definitions of skin problems on residual limbs, we conclude this article with a system for classification.

Key words: amputation, epidemiology, lower-limb loss, prosthetic limb, rehabilitation, residual limb, review, skin diseases, skin integrity, skin problems.

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Researchers Dupret-Bories et al recently tested a titanium tracheal prosthesis in sheep to determine the best surgical implantation method. In time, the prosthesis may serve as a substitute for laryngeal cartilage. To learn more about this novel prosthesis, see the slide show, read the article, and listen to the podcast describing the research and other published research in Volume 48, Issue 7.