Skin Complications in Lower Limb Amputees Due to Prolonged Prosthesis Use: A Narrative Review

Abstract

Background: Several types of skin problems can occur due to prolonged use of prosthesis in lower limb amputees due to continuous contact between the device and skin, generation of warmth, increased sweating, and opportunistic microorganisms. These skin problems can lead to discontinuing prosthesis use and poor functional outcomes. Objectives: This study aimed to identify the various skin complications that can occur in lower limb amputees due to prolonged prosthesis use and their prevalence. Study design: This study is a systematic literature review. Methods: Three databases were searched using the relevant search terms and applying the inclusion and exclusion criteria to identify studies suitable for this review. Studies were finalised by scanning the titles and abstracts for relevance, and the quality of the studies was established using the CASP critical appraisal tool. Results: Fifteen studies were identified, and the information obtained from these studies was divided into four categories: incidence and prevalence of skin problems in lower limb amputees, types of skin problems, determinants of skin problems, and unconventional prosthetic devices. Conclusion: Skin problems in 60% of lower limb prosthesis users include pressure ulcers, hyperhidrosis, lesions, infections, sores, irritation, redness, and calluses. The material and fit of the prosthetic device are important determinants of skin problems, followed by the level of physical activity and environmental temperature and humidity. Newer technologies, such as osseointegration, are associated with comparatively fewer and less severe skin problems, and these technologies should be further explored in future studies.