clinical teaching - Prosthesis care

2. PROSTHESIS CARE
PRINCY FRANCIS M
I Yr MSc (N)
JMCON

3. DEFINITION
• A prosthesis is an artificial replacement for any or all
parts of the lower or upper extremities.
• It is a device that is designed to replace, as much as
possible, the function or appearance of a missing limb or
body part

4. PURPOSE
A prosthesis is used to provide an individual who has an
amputated limb with the opportunity to perform
functional tasks, particularly ambulation (walking) which
may not be possible without the limb

5. COMMON TYPES OF PROSTHESIS
 Lower leg and foot.
 Leg with knee. For amputations above the knee, the prosthesis
has both a knee and ankle joint.
 Arm and hand. The oldest and most commonly used prosthetic
arm is operated with the body's own movements

6. PARTS
• A socket into which the stump of the amputated limb
fits
• The suspension, which holds the prosthesis onto the
stump
• The shaft
• The foot, hand, or hook
• A covering for cosmetic appearances
The socket is often lined with foam or silicone to protect
the stump. Special socks are also worn over the stump to
ensure a proper fit and improve comfort.

7. PROSTHESIS FITTING PROCESS
• 6- 8 weeks after surgery
• Model – a plaster cast or scan of limb
• Individual needs, current weight, health status, condition of residual
limb, goals for life.

8. MAINTENANCE AND CARE OF PROSTHESIS
 The prosthesis is designed for use in normal
conditions and environments.
It has not been designed for use in:
• Wet environments
• Activities that will include unusually high impacts
• Chemical environments that may alter the
structural integrity of the prosthesis.

9. 1. WEARING PROSTHESIS CORRECTLY
a. Make sure your prosthesis
fits properly.
• Properly fitted in order to
ensure their functionality and
comfort.
• Daily adjustments to achieve
a proper fit.
• Take advise from prosthetist,
how to properly fit
prosthesis.

10. b. Be prepared to refit prosthesis each day
• Make small adjustments during
the day to help keep you
comfortable and maintain your
prosthesis.
• Humidity can cause limb to swell
and alter the fit of prosthesis.
Place a bandage on the stump to
decrease swelling when not
wearing the prosthesis.
• Cold temperatures can cause limb
to shrink.

11. c. Keep extra supplies handy
Helps to refit prosthesis whenever
needed.
• Stump or pull socks
• Bandages
• Antibiotic ointment
• Antihistamine ointment
• Antiperspirant
• Tool kit

12. d. Keep your prosthesis dry
• Helps to keep limb safe from
infections or rashes and protect
the prosthesis from additional
wear.
• If prosthesis becomes wet, take it
off and dry it completely before
wearing it again.
• Moisture can build up inside your
prosthesis in hot temperatures.

13. 2. CLEANING THE PROSTHESIS
a. Clean the gel liner.
• Remove the liner from the prosthesis.
• Spot clean the outside of the liner if
needed.
• Turn the liner inside out.
• Wash the gel section of the liner with
anti-bacterial soap and warm water.
• Fully rinse the soap off of the liner and
dry it with a clean cloth.
• Turn the liner right side out and store it
for future use.

14. b. Clean your prosthesis socks or sheaths daily
• Washing a sock helps to keep it
clean and restore it to its
intended shape.
• Mild soap and water

15. c. Care of socket
 Cleaning socket
• Clean the inside socket at least
once a week with soap and water.
• Lightly spray the socket with an
alcohol-based cleaner.
• Wipe the socket dry.
• Make sure to keep any locking or
pin mechanisms clean and free of
obstructions.

16.  Care of finish
Maintenance and use of valve
 powder should not accumulate in the valve
 Never use tools to tighten or loose
 Valve is tightened by turning in clock wise with fingers.

17. d. The Knee friction mechanism
 Adjustment is needed when shin swings through too rapidly or too slowly.
 Notify prosthetist
 Make replacement if needed

18. e. Shin
• Guard against contact with sharp objects
f. Leather
• Clean and dry
• Use saddle soap
• If leather become stained or smelly , replace it .

19. g. Be careful when cleaning your prosthesis
• Learn from prosthetist how to safely clean
prosthesis.
• Long-term exposure to salt water can corrode parts
of prosthesis.
• Make sure there is no dirt stuck in the pin lock
system.
• Always remove and clean the inside of a foot shell
to avoid trapping corrosive or damaging material
inside.
• Electrical components, mechanical devices and
certain models of prosthesis can all be damaged by
water or corrosive cleaning agents.

20. h. CAUTION
 Return the limb to the prosthetist at regular intervals to check on wear
and breakdown of parts.
 Do not use sandpaper, files, knives, rasps, saws or make any repairs on the
prosthesis.

21. 3. MAINTAINING PROSTHESIS
a. Report any issues to your
prosthetist.
• Making an adjustment to fix
some issues
• if encounter a problem or don't
know how to fix or are unsure of
what to do, contact prosthetist.

22. b. Check for loose screws, bolts or other
mechanical parts on prosthesis
• Keeping all parts of prosthesis in
their proper position will help
ensure a comfortable fit,
continued function and prolonged
durability.
• Every day while removing
prosthesis before going to bed,
examine it for loose parts or
damage.
• Seek assistance if needed

23. c. Listen for unusual noises coming from
prosthesis
• Any unusual clicking, grinding or
popping noises should be
investigated.
• New clicks, scraping sounds or
squeaks might indicate a
problem with prosthesis.

24. d. Keep an eye out for any cracks or breaks
that appear on prosthesis
• Regularly check prosthesis for any
signs of cracking or breaking.
• Even a small crack should be
addressed with prosthetist.
• Always check prosthesis for cracks or
tears before wearing it for the day.
• If plan for traveling, make sure
prosthesis is in a suitable condition
before leaving.

25. 4. KEEPING LIMB CLEAN AND HEALTHY
a. Wash your limb daily.
• Skin is at risk for becoming irritated or infected
due to moisture.
• Clean your limb everyday properly and
completely
• Clean and dry limbs both before and after using
prosthesis.
• A small rash or irritation could turn into an ulcer
or cut, prevents from using prosthesis until it
heals.
• Check for blisters, sores or other signs of
irritation.
• Use a mirror or get someone to help.
• Before bed, clean the limb with mild soap and
water, pat dry, and put a small amount of lotion
on the limb and massage it gently into the skin.

26. b. Bathe at night, rather than in the morning
• Hot water or the position of
placing limb during a bath or
shower, some swelling may occur.
This swelling can affect the fit of
your prosthesis.
• it's a good to bathe in the
evening, when ready to take
prosthesis off at night.
• Bathing may affect new amputees
the most, causing their limb to
swell and changing the fit of their
prosthesis.

27. C. MONITOR SKIN FOR SIGNS OF IRRITATION OR
INFECTION
• Irritation
• Red areas
• Any breakdown of the skin
• Dry or cracked skin
• Abrasions
• Ingrown or infected hair follicles
• Skin ulcers
• Discharge of fluid or pus
• Increased swelling

28. NURSING MANAGEMENT
• Help to cope up with permanent loss
• Conditioning and shaping the stump for proper fitting of prosthesis
• Good bandaging technique
• Apply bandage in day and night during shaping process.
• Remove and reapply twice daily
• Criss cross or spiral pattern

29. REFERENCES
• Smeltzer CS, Bare GB, Hinkle LJ, Cheever HK. Brunner & Suddarth’s
textbook of Medical-surgical nursing. Volume I. Twelvth edition.
NewDelhi:Wolters Kluwer (India) ; 2011
• Lewis LS, Dirksen RS, Heitkemper MM, Bucher L. Lewis’s Medical Surgical
Nursing Assessment and management of clinical problems. Second edition.
Volume 1.India: Reed Elsevier; 2015
• https://www.webmd.com/a-to-z-guides/using-prosthetic-limbs#1
• https://www.wikihow.com/Care-for-Your-Prosthesis