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Manage Residual Limb Volume with These Tips

    Managing volume changes in the residual limb is crucial for a comfortable and safe prosthetic limb-wearing experience. This is because the fit of a prosthesis can be greatly affected by size variations in your residual limb, which can lead to skin irritations that make it difficult to continue using the prosthesis. This is where the importance of a volume management system comes in.

    Use these tips to manage your residual limb volume.

    A volume management system can look different depending on the person. But it includes tools that help manage volume fluctuations in the residual limb. A sample volume management system can consist of prosthetic socks (ideally in different thicknesses) and a gel sheath.  

    Prosthetic socks  

    Prosthetic socks are your first line of defense against the consequences of volume fluctuations in the residual limb. The residual limb’s volume naturally fluctuates throughout the day due to fluid retention, physical exertion, and post-operative swelling. Using different thicknesses of prosthetic socks is a simple and effective solution for a consistently comfortable prosthetic limb fit.

    So, having a complete set of prosthetic socks in various thicknesses is essential. This allows you to adapt to any change in residual limb volume easily. However, if managing volume solely with prosthetic socks becomes difficult, it’s best to consult an orthopedic technician, as this may indicate a long-term variation in volume. New amputees often experience such variations during the post-operative phase while the limb stabilizes. However, they can also occur later because of weight fluctuations or changes in the muscular structure of the limb. 

    How and when to wear prosthetic socks  

    Knowing how and when to wear prosthetic socks is essential for effective volume management. If you notice excessive movement of the residual limb within the socket or if the limb can be easily inserted without resistance, it may be necessary to compensate for volume variations.

    The prosthetic sock is designed to be worn over the prosthetic liner, with the ability to layer multiple socks to get the preferred thickness. The measurement for sock thickness is referred to as plies, examples being 1-, 3-, and 5-ply prosthetic socks.

    On the other hand, it’s critical to observe signs suggesting a need to lessen the sock thickness, particularly when the distal end of the socket isn’t in contact. In these situations, the number of sock layers should be reduced until a suitable fit is obtained.

    Gel sheath  

    A valuable addition to your residual limb volume management system is a gel sheath. It provides a barrier between your skin and prosthetic socket, reducing friction and shear. Additionally, it can tighten a loose socket.

    The thickness of the gel sheath varies from 1.5mm at the top to 3mm. This allows you to reduce the number of sock plies by 5-10 ply thickness while still protecting your skin from abrasions and friction. So, incorporating a gel sheath into your volume management toolbox ensures you don't have to tolerate a loose socket all day long, and effectively reduce a 25-ply sock fit.

    ALPS Skin Reliever  

    If you’re considering adding a gel sheath to your prosthetic sock collection, you might want to check the ALPS Skin Reliever. Made with styrene gel and using ALPS EasyGel technology, the ALPS Skin Reliever compensates for volume loss in the residual limb. It features a uniform thickness of 1.5mm at the proximate end, gradually increasing to 3mm at the distal point for maximum comfort.

    The ALPS Skin Reliever also reduces shearing and abrasions on the skin of the residual limb. It’s designed to be worn directly against the skin of the residual limb beneath the prosthetic liner. But if you prefer not to use a prosthetic liner, the ALPS Skin Reliever is a versatile option as it’s compatible with prosthetic knitted socks. Adding an Alps Skin Reliever to your sock routine can reduce your sock ply by 3-10 plies.

    Bottom line  

    To ensure a comfortable and safe experience while wearing a prosthesis, managing volume variations in the residual limb effectively is crucial. Prosthetic socks provide a practical solution to accommodate daily size fluctuations. By using socks of various thicknesses and being aware of signs that indicate necessary adjustments, individuals can maintain the proper fit and durability of their prosthetic sockets.

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