Prostheis care

clinical teaching - Prosthesis care

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

2. 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

3. 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

4. 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

5. 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.

6. 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.

7. 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.

8. 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.

9. 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.

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

11. 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.

12. 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.

13. 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

14. 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.

15. 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.

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

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

18. 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.

19. 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.

20. 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.

21. 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

22. 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.

23. 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.

24. 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.

25. b. Bathe at night, rather than in the morning H ot 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.

26. 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

27. 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

28. 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