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Resources Patient Education Wearing and Caring for Your New Prosthesis

THE SHEATH: The thin nylon sock which your prosthetist may recommend that you wear next to your skin.  You should wear a CLEAN sheath each day.  Machine wash warm on delicate cycle, mild detergent, no bleach – tumble dry low heat.

THE LINER: The silicone sleeve which will attach (suspend) the prosthesis on to you. You may wear this next to your skin or over a sheath.  Start with it inside out, place firmly against the bottom of your residual limb (stump), and roll it on as your prosthetist shows you.  You will begin wearing this all day even before you receive your prosthesis – this will help reduce your swelling and accustom you to having total contact on your residual limb.  At bedtime, remove the liner by rolling it off (in the opposite motion of rolling it on), wash it with a non-antibacterial soap and water, rinsing well and leaving it open (right side out) to the air to dry overnight.  Alternately, your prosthetist may instruct you to spray the inside of the liner generously with an alcohol/water mix and wipe it clean with paper towels, then leave it to dry completely.  

THE SHRINKER: The elastic stocking you have been wearing since your residual limb has been healed – you should continue wearing this at night to keep your swelling under control, especially during the first few months of prosthetic wear. Wear a CLEAN shrinker each evening.  Hand or machine wash in warm water with mild detergent, no bleach – machine wash and dry on lowest permanent press setting.

THE SOCKET: The hard plastic portion of your prosthesis that fits over your residual limb. It is custom-made to your measurements at the time of fitting, but as the size of your residual limb decreases, it can be modified for optimal fit and comfort.  It will likely need to be replaced at least once or twice as your limb changes over time.

THE SOCKS: The thick white socks you may wear over the liner to provide cushioning and adjust the fit of the socket.  They come in different thicknesses called “ply” – the most common sizes are 3-ply (yellow writing) and 5-ply (green writing).  You may also be given thinner 1- or 2-ply socks to help you customize the fit of your socket. You will probably find that you need fewer, if any socks to put on (“don”) your prosthesis in the morning.  However, you will most likely find that the socket becomes loose fairly quickly, and you will be able to take off the leg and put on one or more socks to make it fit better.  You will know it is loose if you feel like you are sinking into the socket too deeply or if the prosthesis begins to rotate.  Many people find they need to add sock ply one or more times throughout the day as the total contact of the prosthetic socket combined with the action of the muscles in their residual limb reduce the size (volume) of the limb further.  Frequent volume changes are expected throughout the first few months and learning how to continually adjust the fit of your socket as needed throughout the day can be a challenge.  Very warm weather, what you eat, and how active you are can all affect your volume.  However, the amount of change should begin to decrease after several months as your residual limb takes on a more permanent shape.  Machine wash and dry these socks on warm using a fabric softener sheet if desired (not a liquid softener).  If bleach is needed, use cold water wash.  Do not hand wash.  

This will be individual for each patient and depends on factors such as your skin condition and level of healing, whether or not you are diabetic, your activity level, etc.  Our goal is to get you to a full day of wear as quickly and safely as possible.  Initially, you will wear your prosthesis for shorter periods of time and remove the leg, liner, and socks after each period to check your stump for areas of redness, blistering, or breakdown (open spots). If you notice there are areas of breakdown, contact your physician immediately for skin care instructions. Also, inform your prosthetist immediately of the location of the problem. When blisters or breakdown occur, these areas should be completely healed before the prosthesis is worn again.  CONTINUING TO WEAR YOUR PROSTHESIS OVER BLISTERED OR BROKEN SKIN CAN LEAD TO MORE SERIOUS SKIN ISSUES WHICH MAY KEEP YOU OUT OF YOUR LEG FOR AN EXTENDED PERIOD OF TIME.

As long as your skin remains in good condition, wearing time can be steadily increased until you are wearing your prosthesis all day.  However, it is not worth the risk to suddenly double or triple your wearing time and then have to stay out of your leg for several days, due to a skin problem.  You may feel able to tolerate 8 hours of wearing time, but chances are that your skin can’t!  As you begin wearing your prosthesis, do not try to walk around on it the whole time – sitting time counts too – in fact the therapist may have you wear it only for sitting or transfers initially, until you learn to trust the leg and balance on it properly to begin walking.

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