Welcome to our "All About Prosthetic Liners" series where we break down the characteristics and uses of one of the most popular prosthetic components. In this installment, we talk about how to wear a prosthetic liner correctly, as well as essential care tips to ensure that your liner is clean and ready for use. If you are interested in the different types of liner suspension systems, please head to part 1. Meanwhile, part 2 dissects the materials used to create prosthetic liners.
Now that we’ve discussed the foundation of prosthetic liners—what they’re made of and the different types of suspension systems—we’ll move on to the actual use of prosthetic liners.
Donning and doffing techniques
The proper technique for applying a prosthetic liner is key to prolonged comfort, especially when you wear a prosthesis for hours. But before donning your prosthetic liner, make sure that your skin is clean and dry. Then, invert the liner so that the silicone or gel surface is on the outside and fabric and logo are on the inside.
If you use a pin suspension system, align the pin of the liner with your residual limb so that the pin isn't canted to one side. If the pin is incorrectly positioned, locking it will be difficult.
Regardless of what suspension system you use, simply roll the liner onto your residual limb; as you do this, avoid pulling which can overstretch the gel or silicone and damage the liner. Pulling your liner onto your limb—especially the remaining few inches of liner—can cause skin irritation along the liner's edge and possibly cause premature wear from your nails.
Your donning technique affects how freely you can sit, walk, and move. For below-knee amputees, bend your knee—a roughly 20-degree bend—while rolling your prosthetic liner over the knee. This technique will ensure comfort while sitting and walking. Meanwhile, transfemoral amputees would do well to straighten their hips; this provides a broader range of motion in the hip area.
Meanwhile, to remove the liner, employ the same rolling motion—roll it back down onto your residual limb without over stretching or pulling.
Common side effects of wearing prosthetic liners
Sweat or excessive sweating is one of the most common side effects of wearing a prosthetic liner. New prosthetic liner users can expect six months of excessive perspiration while their body adjusts to wearing a liner.
This is because, unlike wearing socks, prosthetic liners are not designed to absorb sweat from the surface of your residual limb. However, the good news is that in most cases, sweating can be minimized by using an underliner sock or prosthetic antiperspirant.
(Related Reading: Prosthetic Guide - Help I'm constantly sweating inside my prosthesis)
Another side effect is an allergic reaction. Although material-induced allergic reactions are rare (manufacturers use biologically neutral materials), it can be likely sparked by inconsistency in cleaning or local infections. Another possible reason is that the liner needs to be replaced.
When to replace
The life cycle of a prosthetic liner varies, depending on the user’s physical features, daily activities, and hygienic habits. However, despite the amount of care, prosthetic liners will eventually degrade, and contaminants will enter the gel or silicone, leading to skin irritation or at the very least, discomfort.
Active amputees typically replace their liners twice a year at most. You’ll know it’s time to buy a new one when you notice the following signs: discoloration, hardening, and when the outer layer fabric separates from the inner layer. Your prosthetist can also help you determine when your prosthetic liner needs to be replaced.
Cleaning and storage
Wash the inner surface of your liner daily. This removes bacteria, sweat, and oils which are naturally produced by the skin. Dry the inner surface with a clean, soft cloth after washing. Meanwhile, the outer surface of the liner can be cleaned less frequently since it’s not in direct contact with your skin.
Prosthetic liner manufacturers usually provide specially designed liquid soaps. Alternatively, you can use baby soaps, which are pH neutral and don’t contain fragrances.
After cleaning and drying, store the liner horizontally and keep it away from heat sources, such as direct sunlight. Aggressive chemicals, which may be present in your cleaning supplies, should also be stored away from your liner. Watch out for ingredients like phthalates, triclosan, ammonia, chlorine, and sodium hydroxide, among others.
Other manufacturers have specific storage instructions for their products and will have specially designed hooks or drying stands available for purchase.
What do you think of these tips? Have you tried them yourself? Do you have any additional tips you can share? Please share your thoughts in the comments section below.