Author Topic: A question about sockets  (Read 3754 times)

Offline kevins

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A question about sockets
« on: July 07, 2008, 08:25:44 AM »
Hi all, I'm new here but not a new amputee.  I am a 27 year old RAK due to trauma, it will be 7 years in November.  My question is this.  I have a lot of scarring and skin grafting covering my stump and have always used a liner with the pin/lock system.  I would really like to try and use a suction socket system but previous attempts have failed as I quickly blister and breakdown etc.  Has anyone in a similar situation been successful in the use of a suction socket and has anyone used the ossur seal-in liner?

thanks
kevin
kevin s.
rak trauma 11/2001

Offline Steve C

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Re: A question about sockets
« Reply #1 on: July 07, 2008, 09:27:03 AM »
I'm a 45 year old BKA (since 2000). My (shortish) stump is 3/4 skin graphs. I have tried the pin lock system once but never liked it and I never really wore the leg. It may have been my socket at the time and not the pin at all. Who knows. Besides my first non-weightbearing leg I have always used the suction seal.
I use Alpha liners and the Alpha sleeve.

 Out of curiosity, why are you wanting to go with the suction seal?
Where ever I go, I'll always have one foot in Ireland   /   I'm not a complete fool. Some parts are missing.

Offline Annie

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Re: A question about sockets
« Reply #2 on: July 07, 2008, 10:39:54 AM »
I'm a 45 year old BKA (since 2000). My (shortish) stump is 3/4 skin graphs. I have tried the pin lock system once but never liked it and I never really wore the leg. It may have been my socket at the time and not the pin at all. Who knows. Besides my first non-weightbearing leg I have always used the suction seal.
I use Alpha liners and the Alpha sleeve.

 Out of curiosity, why are you wanting to go with the suction seal?

Hope you don't mind me butting in here, but Steve, can I ask how short your stump is and can you describe the suction seal, is it similar to the harmony?  only asking as I am b/k also (bilateral) and my stump is currently about fifty per cent skin grafted (front and underneath of stump).  I have spent ten years having horrendous problems getting a leg to fit and am wearing an old fashioned type limb with thigh corset, now thinking of the revision route as they seem now to be having difficulties making even this, however am getting different feedback from people I speak to, its been questioned why I need surgery, I originally did manage to wear a PTB on this side but just can't get one made now that is wearable, however, although I have tried some types of liner, have not been offered Alpha.  If I have surgery my stump is probably going to be left at about 11 cm, and again I will still have the front skin grafted, but hopefully more padding on the end of it, however I am being told that the best or more or less only way to go with that is the Harmony route.  Just wondered if this is the same or similar to the suction seal.

Offline pyourke

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Re: A question about sockets
« Reply #3 on: July 07, 2008, 12:31:47 PM »
Hi Kevin, I've been a BAK (trauma) for 34 years, and been using suction sockets for 26 years. I've got about 10 square inches of skin grafts on the bottom / back of one stump. I used conventional sockets and wool socks for the first 8 years and by then my prosthetist felt that the grafts had matured enough to take the suction socket. Fortunately the grafts don't contact with the socket due to the shape of the stump at the bottom (a hollow where the grafts are), so I've never had any rubbing. The edges have occasionally gotten a little irritated by the end of the day but with a little skin creme at night, they were always good to go by the morning.

I tried the Ossur Seal-In-Liner last year, but had to switch back to suction due to irritation and welts at the tops of the sockets. My stumps are fairly long and with the seal being near the bottom, there was too much rotation at the top causing the skin to stick at the top of the liner to the sides of the sockets and breaking down. Unfortunately I was unable to leave the liners long enough to fold over the sockets due to the fact that being bilateral, I felt much more piece of mind, I use silesian belts in addition to the suction in case of losing suction when I was out of the house. The belts precluded rolling the liners over the tops as they would have torn very quickly.

I must say though that the seal-in-liner definitely felt comfortable if it wasn't for the 'welting' which I understand isn't normal. So maybe they would work for you if you don't have a suspension belt. I also loved the ease of donning them rather than using pull bandages. I've never used liners with pins so am unable to compare them but I'm led to believe from my prosthetist that the seal-in-liner mostly solves the problem of pin liners pistoning within the socket as they are held more securely in the socket.
« Last Edit: July 08, 2008, 03:39:13 PM by pyourke »
Peter
BAK since '74

Offline Steve C

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Re: A question about sockets
« Reply #4 on: July 08, 2008, 05:57:40 AM »
Where ever I go, I'll always have one foot in Ireland   /   I'm not a complete fool. Some parts are missing.

Offline chrysochloridae

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Re: A question about sockets
« Reply #5 on: July 08, 2008, 04:17:35 PM »
Annie,

I wear the alpha spirit sock and use the alpha suspension sleeve. As far as being air tight it is not. The probable suspect is the fact that I have about 3 sleeves and I think they all have holes in them (where they rub on the top of the socket). If theres a hole, air will get in.


Steve,
Have you tried any other suspension sleeves? The Ossur Iceflex Endurance is pricey but lasts a remarkably long time; in my experience is the muost durable sleeve on the market.
Slightly cheaper is the Streifeneder ContexGel sleeve (available from RSL Steeper in the UK) - also much more durable than the Alpha Sleeves (i've found the Alpha Sleeves don't last 2 minutes!)


Harmony System:-
Is basically a suction system, but its meant to provide better circulation to the limb. It Costs alot and weighs alot...


Suction sockets.
Suction sockets are great if they are right.
Advantages over the Lock and Pin system for people who find that the end of their stump is very sensitive and the pressure from the total contact (lock and pin system) is uncomfortable; a (comfortable foam) End Bearing pad can be put in the end of a Suction Socket to increase comfort at the end of the stump. Also less pistoning (i.e. leg holds on better (greater suspension))
Disadvantages include:- Liner and sleeve = extra bulk around knee, leg is doesn't bend back as far. Increased cost of replacing sleeve and liner. if socket isn't fitting right, a nasty 'air 'wooshing' noise can appear

Offline Cheri

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Re: A question about sockets
« Reply #6 on: July 08, 2008, 08:48:23 PM »
Hi Kevin,

I've worn both a full suction socket and then tried ossur's seal-in liner for a few months.  I haven't had to deal with skin breakdown like you mentioned, so I can't address that. 

My biggest problem with full suction is the daily anxiety it caused me, for fear of it falling off!  The seal-in liner was much better, but I still didn't trust it 100% and a few months into wearing it I had the opportunity to try a vacuum system (I wear the NPS from Stan Patterson in Orlando) and I LOVE it.  I NEVER have to worry about it falling off, rotating, sweat, or anything like that.  It's very comfortable in every aspect. 

Oh, I should mention that my residual limb is very short- 4" (AK), so it's understandable that I would have these issues.  If you have a long residual limb, the seal-in might work for you.  Other wise, I hands down recommend the current socket that I'm wearing. 

Good luck to you,
Cheri
Monterey, CA
Rt. AKA, 1993
Osteogenic Sarcoma
C-leg
NPS Vacuum Socket

Offline JClark

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Re: A question about sockets
« Reply #7 on: July 09, 2008, 09:42:26 AM »
I've been wearing a full suction socket since 2003 (when I had the amp) and have never had it fall off.  In fact, I've had people pull my leg and try and pull it off and they can't.  However, with some sweating, it does get damp and has slipped a bit, but still wouldn't come completely off.

I wouldn't skip the suction just because of this fear though.  And perhaps the vac systems would be better, I've never used them.  But just wanted to put in my 2 cents about my trust in suction.  I have no skin grafts.
North-East Pennsylvania
+Left foot------------+Right foot---------------+
|Accident 8/31/2002 |ankle fusion 1/8/2008  |
|Amp 7/11/2003      | RBK (Ertl)    4/7/2010 |
|Ertl June 2005        |                                  |
+---------------------+-------------------------+

Offline chrysochloridae

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Re: A question about sockets
« Reply #8 on: July 09, 2008, 01:55:37 PM »
You can always try a suspension sleeve (BK) or a TES Belt (AK) to give you extra confidence in the suction... if you've got a 'Back Up' Suspension then its much less likely to come off; (suspension sleeve with BK Seal In liner will be ULTRA secure)  8)

Offline Robogirl

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Re: A question about sockets
« Reply #9 on: July 09, 2008, 09:28:16 PM »

I believe Kevin is an AK,  so the BK system described above would not help him.   Ugh. The thought of a TES belt to help keep my leg on sounds horrible - especially in the summer.  I know people who have worn the seal-in and they have problems with sweat in the summer.  And having a suction socket on so tight I couldn't pull it off doesn't sound comfortable either!  I wore one of those for most of my life, but  I wouldn't trade my AK vac system (same as Cheri's) for anything, and I know that Stan Patterson has fit quite a few patients with skin grafts who could wear nothing else.  He's also taught his method to a lot of practitioners around the country (and world).  It doesn't involve any mechancial parts; just a vacuum chamber inside the socket.  Google him, Kevin, and see what you think.
"The race does not always go to the swift, but often to those who keep on running."

Offline pegleg jack

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Re: A question about sockets
« Reply #10 on: July 10, 2008, 09:15:15 AM »
I understand why some of you like the vacuum and suspension system, am a bilateral bka my self and use the pin/lock system, and am using the ICEROSS DREMO liners and is dose get hot and muggy down here in EAST TEXAS, and at time i have taken my liner off and poured sweat out of it put have never had on come off due to it, the have slipped some, would like to go to the vacuum system put my doctor and CPO feel that it is now right for me because i have to keep my blood real thin and am on rat posion(blood thinners) and they feel that i could possibly start pulling blood through my leg with the vac system, dont get me wrong i like what i have and get everything done that i need to do wearing this system,
you-all have a great day.