INDIRANI COLLEGE OF NURSING
LEVEL OF STUDENT - [Link](N) II yrs
PROSTHESIS
Presented by
Mrs. Dhanasundari. G
Lecturer in Nursing (MSN)
ICON
HOD PRINCIPAL
PROSTHESIS
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
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
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
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.
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.
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
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.
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.
c. Keep extra supplies handy
Helps to refit prosthesis whenever needed.
Stump or pull socks
Bandages
Antibiotic ointment
Antihistamine ointment
Antiperspirant
Tool kit
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.
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.
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
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.
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.
The Knee friction mechanism
Adjustment is needed when shin swings through too rapidly or too slowly.
Notify prosthetist
Make replacement if needed
Shin
• Guard against contact with sharp objects
Leather
• Clean and dry
• Use saddle soap
• If leather become stained or smelly, replace it
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.
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.
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
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
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.
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.
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.
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.
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
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
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 [Link]: Reed
Elsevier; 2015
• [Link]
• [Link]