Often not given the proper attention they deserve, prosthetic liners are crucial for added comfort and greater efficiency. These devices can dramatically improve an amputee's quality of life, so choosing suitable prosthesis liner material is vital for maximum protection and healthy recovery.
PrimeCare produces custom prosthetics in Albuquerque and Las Cruces. We've helped many patients with various needs choose suitable prosthetic liners. This brief guide covers the different types of liners and their benefits, as well as prosthetic liner care and technological innovations.
What Is a Prosthetic Liner and Why Is It Important?
A prosthetic leg liner is a unique lightweight sheath, like a second skin, made from silicone or other synthetic materials that fit snugly and comfortably around an amputee's residual limb.
Wearing amputee liners offer better fitting, increased comfort, and protection against moisture and skin issues. They keep prosthetics in place and reduce the risk of sores and itching.
If you require a prosthesis either above or below the knee, wearing a prosthetic liner is imperative. Essentially, amputee liners provide comfort and protection to the residual limb throughout the day.
Types of Prosthetic Liners
When looking at prosthetic leg liners, the two main factors to consider are pliability and durability.
Below are the most commonly used types:
— Durable Silicone Liner
Medical-grade silicon liners for prosthetics are non-irritating and comfortable on the skin. They do not cause a reaction with substances such as sweat and have excellent shock-absorbing properties to lessen shearing forces that harm the limb and scar tissue.
Regarding its softness and robustness, silicone liners are a mid-range choice that holds some of the elasticity of TPE liners but has more durability than urethane liners. Additionally, they are hypoallergenic and capable of withstanding prolonged usage and daily stretching.
— Urethane Liners
Stiff, inflexible urethane liners offer high durability and aid even pressure distribution. Urethane liners are particularly well-suited for users with a high degree of activity who use prosthetic limbs with active vacuum sockets. These liners have a higher tensile stiffness, which provides improved suspension for active users.
— Thermoplastic Elastomer (TPE)
TPE liners are the perfect choice for those with atypical residual limb shapes, as the liner's soft and pliable material molds to an individual's limb shape over time, allowing for ultimate comfort and convenience. Moreover, the ability of TPE to absorb shear forces makes it a popular material for prosthetic liner design. This property enables prosthetists to pre-stretch the liner before fitting, making it a comfortable option for amputees, particularly those with sensitive skin or skin grafts, allowing them to walk without straining their limbs.
— Mineral Oil Gel
Those with a bony residual limb or hypersensitive areas can benefit greatly from mineral oil gel liners. They are soft and forgiving and protect against rubbing within the prosthetic socket. Additionally, mineral oil gel liners contain vitamins that help keep the skin healthy and moist, reducing the risk of skin breakdown. The only drawback is less durability compared to other types of liners.
Urethane liners have exemplary "flow properties," which gives them the capacity to shift their gel away from areas where the pressure is higher, allowing for an even distribution of pressure and a more comfortable fit. These characteristics make them a good choice for sensitive, bony, or scarred residual limbs and active individuals who need a liner to withstand high levels of wear and tear.
The copolymer is best for amputees with sensitive skin or low activity levels due to its soft, cushiony, and highly elastic properties. This thermoplastic elastomer also contains skin-friendly white oil, which provides extra protection to residual limbs with dry skin. When it comes to suspension, copolymer performs best when used with pin or suction suspension.
— Prosthetic Sleeves
Prosthetic sleeves are elastic garments worn over prosthetic limbs to provide a comfortable and secure fit. They also help to reduce skin irritation caused by friction during wearing and movement. Made from soft, stretchy materials such as spandex or lycra, which allow the limb to flex easily, they also contain fabric liners that reduce sweat and keep the prosthesis from slipping. Prosthetic sleeves may also be fabricated with pockets for storing small items and providing additional support to the limb.
To clarify and reiterate: A prosthetic sleeve (shrinker sleeve/stockinette) makes it easier to wear a prosthetic liner. It distributes pressure and reduces volume, friction, and rotation. Prosthetic liner cushions and shapes the residual limb provides an even interface between limb & socket, and reduces friction/provides feedback.
Prosthetic Liner Shapes & Thicknesses
Prosthetic leg liners vary in shape and thickness, with cylindrical and conical shapes offering more uniform protection. Cylindrical liners range in thickness from 5 mm to 10 mm, while conical liners usually vary between 3 mm to 7 mm.
Custom liners are also available to accommodate those with typical limb shapes. These liners are thicker in areas such as the bottom front or side, which protects prominent bones. They also have thinner areas that allow for a greater range of motion, such as behind the knee, to accommodate knee flexion.
What's the Typical Lifespan of Amputee Liners?
No matter the user's physical features, daily activities, and hygienic habits, a breathable prosthetic liner will eventually degrade, leading to skin irritation and discomfort. It's common for very active amputees to replace their liners twice a year.
Signs that it is time to buy a new prosthetic liner include discoloration, hardening, and a separation between the outer and inner layers of fabric. If unsure, you should consult your prosthetist to determine if a liner replacement is needed.
How Often Should I Wear My Liner Prosthesis?
If you are breaking in a new liner, your prosthetist will provide specific instructions for you to follow. If you experience any skin irritation after putting the liner on, please stop using it and contact your prosthetist immediately.
Below is a general guideline for breaking in a new liner:
- Day one: Wear your liner for one hour in the morning and one hour in the afternoon.
- Day two: Wear your liner for two hours in the morning and two hours in the evening.
- Day three: Wear your liner for three hours in the morning and another three hours in the evening.
- Day four: Follow the same step above, but extend the duration to four hours.
- Day five: Wear your liner the whole day.
If at any point during the process, your skin becomes irritated, then proceed to the next step once you've spoken to your prosthetist, primarily if blistering or prolonged redness occurs.
Please note: it is normal to experience some redness as your residual limb adjusts to the liner. However, this should subside within 15 minutes of removing the liner.
Prosthetic Liner Care
Follow these tips to prolong the life of your prosthetic liner and learn how to clean a prosthetic leg liner:
- Wash the liner inside out with mild, non-allergenic, fragrance-free soap and warm water. Gently blot dry with a towel, turn right-side out, and leave on the drying stand overnight.
- If the liner is fabric covered, take care not to soak the fabric, as this can weaken its structural integrity.
- Check the liner for signs of damage, both inside and out; schedule an appointment with your prosthetist if there's significant wear and tear.
- Always ensure the liner is clean, dry, and has no debris stuck inside before rolling it on your leg.
- When putting it on, ensure it is inverted and covers the end of the limb; air pockets can lead to unintended suction resulting in water blisters.
How Much Does a Prosthetic Liner Cost in Albuquerque?
A prosthetic liner price can range from $350 to $625 depending on several factors, such as the liner's type and complexity, the materials used, the manufacturing process, additional features, and the product brand.
Advancing Prosthetic Liner Technologies
Pin-locking prosthetic liners have revolutionized prosthetics by streamlining the process of securely attaching a prosthesis to the residual limb.
A prosthetic locking liner uses small removable pins to quickly and securely "lock" into the prosthesis. The pins fit into the socket in various patterns to accommodate individual activities and specific needs.
This customization reduces shear and friction between the limb and the prosthetic socket, yielding a better grip, higher comfort level, and improved control over prosthesis movement.
Not only that but a pin-locking prosthesis and liner enhances the suspension of prosthetic limbs due to their secure and stable fit and even distribution of pressure across the residual limb.
Furthermore, new and innovative prosthetic socket designs are being created to cater to individual anatomy and offer more creative materials such as 3D printed and carbon fiber-based sockets. Through customization, these designs achieve better comfort and fit for the individual based on their anatomy.
Also, these materials are lighter yet more robust, allowing wearers to be more agile and move quickly.
Which Prosthetic Liner Is Right for Me?
When selecting the best amputee liner for you, there isn't a "one-size-fits-all" approach.
At PrimeCare, we start by reviewing your level of comfort and mobility regardless of whether you already have a prosthetic or are a new amputee.
Then we consider your limb's residual shape, suspension technology, and other factors like skin compatibility, comfort, durability, and security.
In other words, your prosthetic liner must accommodate a wide range of daily volume fluctuations, be durable, and maintain a close fit to minimize movement within the socket - this is paramount for maintaining healthy and active lifestyles.
Empowering Lives with Prosthetic Leg Liners
It's essential to talk to your prosthetist when selecting a prosthetic liner. They will discuss the various types in detail, as well as which is ideal for your individual needs and preferences, including comfortability, durability, and cost-effectiveness. As time passes, your body's needs will change, and switching to your prosthetic liner is expected.
At PrimeCare, we always aim to provide liners made from the highest-quality materials that improve mobility and quality of life. We offer a range of direct sockets and above and below-the-knee prosthetic liners from an industry-leading manufacturer, Össur.
Don't hesitate to contact us for more information.