Materiales en interfaces y encajes ortoprotésicos de miembro inferior: evolución y problemas dermatológicos asociados

Publicado

2019-01-01

Materials for lower limb prosthetic and orthotic interfaces and sockets: Evolution and associated skin problems

Materiales en interfaces y encajes ortoprotésicos de miembro inferior: evolución y problemas dermatológicos asociados

Palabras clave:

Prostheses, Splints, Lower Limb, Polymers, Skin Diseases (en)
Prótesis, Férula, Extremidad inferior, Polímeros, Enfermedades de la piel (es)

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Autores/as

Catalina Quintero-Quiroz Universidad Pontificia Bolivariana - Medellín Campus - Centro de Bioingeniería - Grupo de investigaciones en Bioingeniería https://orcid.org/0000-0001-9682-5530
Vera Zasúlich Pérez Universidad Pontificia Bolivariana - Medellín Campus - Centro de Bioingeniería - Grupo de investigaciones en Bioingeniería https://orcid.org/0000-0003-3702-8173

Resumen (en)
Resumen (es)

Introduction: Sockets and interfaces are important elements for lower limb orthoses and prostheses, as they allow for proper contact and fit between the devices and the affected limb or stump.

Objective: To review the different polymers used in the development of lower limb sockets and external prosthetic and orthotic interfaces, their functional requirements and the possible skin problems caused by their use.

Materials and methods: A literature review was conducted using the databases EBSCO, Embase, LILACS, SciELO, ScienceDirect and Scopus.

Results: 47 articles and papers that met the inclusion criteria were retrieved. Thermoplastics, thermosets, foams, gels and elastomers are among the polymers used for manufacturing prosthetic and orthotic interfaces and sockets. However, studies estimate that between 32% and 90.9% of the population that use these devices have experienced skin problems on the affected stump or limb, such as excessive sweating, wounds and irritation.

Conclusion: There is a clear need for further research to develop prosthetic and orthotic interfaces and sockets for lower limbs that can prevent or control damage to the skin of users.

Introducción. Los encajes e interfaces representan elementos importantes para las órtesis y prótesis de miembro inferior, ya que permiten el contacto y ajuste adecuado entre los dispositivos y la extremidad afectada o muñón.

Objetivo. Documentar la variedad de polímeros empleados en el desarrollo de encajes e interfaces ortoprotésicas externas de miembro inferior, sus requerimientos funcionales y los posibles problemas dermatológicos generados por su uso.

Materiales y métodos. Se realizó una revisión de la literatura en las bases de datos EBSCO, Embase, LILACS, SciELO, ScienceDirect y Scopus.

Resultados. Se encontraron 47 artículos y documentos que cumplían los criterios de inclusión. Se enuncian polímeros empleados para la fabricación de interfaces y encajes ortoprotésicos, entre los que se encuentran termoplásticos, termoestables, espumas, geles y elastómeros. Sin embargo, estudios estiman que entre el 32% y el 90.9% de la población que hace uso de estos dispositivos ha presentado problemas en la piel del muñón o la extremidad afectada, como sudoración excesiva, heridas e irritación.

Conclusión. Se evidencia la necesidad de realizar actividades investigativas para el desarrollo de interfaces y encajes ortoprotésicos para miembros inferiores que posean la capacidad de evitar o controlar los daños generados en la piel de los usuarios.

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Citas

International Organization for Standardization. ISO 8549-1:1989 Prosthetics and orthotics —Vocabulary— Part 1: General terms for external limb prostheses and external orthoses. ISO; 1989 [cited 2018 Oct 23]. Available from: https://goo.gl/sAAQcn.

Edwards ML. Lower Limb Prosthetics. In: Olson DA, DeRuyter F, editors. Technologies for Mobility and Locomotion. St. Louis: Mosby, INc; 2002. p. 297-310.

Rajťúková V, Michalíková M, Bednarčíková L, Balogová A, Živčák J. Biomechanics of Lower Limb Prostheses. Procedia Eng. 2014;96:382-91. http://doi.org/cv58.

Ikeda AJ, Grabowski AM, Lindsley A, Sadeghi-Demneh E, Reisinger KD. A scoping literature review of the provision of orthoses and prostheses in resource-limited environments 2000-2010. Part two: Research and outcomes. Prosthet Orthot Int. 2014;38(5):343-62. http://doi.org/cv59.

Hsu JD, Michael JW, Fisk JR. AAOS Atlas of Orthoses and Assistive Devices. 4th edi. Philadelphia: Mosby Elsevier; 2008.

Jin YA, Plott J, Chen R, Wensman J, Shih A. Additive manufacturing of custom orthoses and prostheses - A review. Procedia CIRP. 2015;36:199-204. http://doi.org/cv6c.

.Laferrier JZ, Gailey R. Advances in Lower-limb Prosthetic Technology. Phys Med Rehabil Clin N Am. 2010;21(1):87-110. http://doi.org/bwpj2v.

Cochrane H, Orsi K, Reilly P. Lower limb amputation Part 3: Prosthetics - a 10 year literature review. Prosthet Orthot Int. 2001;25(1):21-8. http://doi.org/fw7cnn.

Campbell AI, Sexton S, Schaschke CJ, Kinsman H, McLaughlin B, Boyle M. Prosthetic limb sockets from plant-based composite materials. Prosthet Orthot Int. 2012;36(2):181-9. http://doi.org/cv6d.

Klute GK, Kantor C, Darrouzet C, Wild H, Wilkinson S, Iveljic S, et al. Lower-limb amputee needs assessment using multistakeholder focus-group approach. J Rehabil Res Dev. 2009 [cited 2018 Oct 23];46(3):293-304. Available from: https://goo.gl/RmxugK.

Chitragari G, Mahler DB, Sumpio BJ, Blume PA, Sumpio BE. Prosthetic options available for the Diabetic Lower Limb Amputee. Clin Podiatr Med Surg. 2014;31(1):174-85. http://doi.org/f5mhq5.

Ghoseiri K, Safari MR. Prevalence of heat and perspiration discomfort inside prostheses: literature review. J Rehabil Res Dev. 2014;51(6):855-68. http://doi.org/f6pv3v.

Meulenbelt HE, Geertzen JH, Jonkman MF, Dijkstra PU. Skin problems of the stump in lower limb amputees: 1. A clinical study. Acta Derm Venereol. 2011;91(2):173-7. http://doi.org/cv6f.

Viosca-Herrero E, Prat J, González JA. Guía de Uso y Prescripción de Productos Ortoprotésicos a Medida. Valencia: Instituto de Biomecánica de Valencia; 2004.

International Organization for Standardization. ISO 8551:2003. Prothèses et orthèses -- Malformations des membres -- Description de la condition de l’utilisateur d’orthèse, objectifs cliniques, et exigences fonctionnelles et biomécaniques de l’orthèse. IS; 2003 [cited 2018 Oct 23]. Available from: https://goo.gl/KJvwgG.

Phillips S, Craelius W. Material Properties of Selected Prosthetic Laminates. JPO J Prosthetics Orthot. 2005;17(1):27-32. http://doi.org/ck83s5.

Jia X, Zhang M, Lee WC. Load transfer mechanics between trans-tibial prosthetic socket and residual limb-dynamic effects. J Biomech. 2004;37(9):1371-7. http://doi.org/cs7t9j.

Zhang M, Turner-Smith AR, Tanner A, Roberts VC. Clinical Investigation of the pressure and shear stress on the transtibial stump with prosthesis. Med Eng Phys. 1998;20(3):188-98. http://doi.org/fg6gsn.

Klute GK, Glaister BC, Berge JS. Prosthetic liners for lower limb amputees: A review of the literature. Prosthet Orthot Int. 2010;34(2):146-53. http://doi.org/ch7b76.

Bosker GW, Walden G. The Interfaces between the Transtibial Residual Limb and the Socket Design. The Academy Today. 2008;4(1):3-9.

Wise DL, Trantolo DJ, Altobelli DE, Yaszemski MJ, Gresser JD. Human Biomaterials Applications. Part III Biomedical Applications of Biomaterials. New York: Humana Press; 1996.

Arun S, Kanagaraj S. Performance enhancement of epoxy based sandwich composites using multiwalled carbon nanotubes for the application of sockets in trans-femoral amputees. J Mech Behav Biomed Mater. 2015;59:1-10. http://doi.org/cv6h.

van der Spoel E, Rozing MP, Houwing-Duistermaat JJ, Slagboom PE, Beekman M, de Craen AJ, et al. Association analysis of insulin-like growth factor-1 axis parameters with survival and functional status in nonagenarians of the Leiden Longevity Study. Aging (Albany NY). 2015;7(11):956-63. http://doi.org/cv6j.

Scholz MS, Blanchfield JP, Bloom LD, Coburn BH, Elkington M, Fuller JD, et al. The use of composite materials in modern orthopaedic medicine and prosthetic devices: A review. Compos Sci Technol. 2011;71(16):1791-803. http://doi.org/bhmr26.

Nelham RL. Carbon fibre reinforced plastic applied to prosthetics and orthotics. J Biomed Eng. 1981;3(4):305-14. http://doi.org/cjzp2d.

Bartonek A, Eriksson M, Gutierrez-Farewik EM. A new carbon fibre spring orthosis for children with plantarflexor weakness. Gait Posture. 2007;25(4):652-6. http://doi.org/dv2pmd.

Kelly BM, Spires MC, Restrepo JA. Orthotic and Prosthetic Prescriptions for Today and Tomorrow. Phys Med Rehabil Clin N Am. 2007;18(4):785-858. http://doi.org/b332gr.

Dasgupta AK, McCluskie PJ, Patel VS, Robins L. The performance of the ICEROSS prostheses amongst transtibial amputees with a special reference to the workplace-a preliminary study. Icelandic Roll on Silicone Socket. Occup Med (Lond). 1997;47(4):228-36. http://doi.org/cm99fh.

Baars EC, Geertzen JH. Literature review of the possible advantages of silicon liner socket use in trans-tibial prostheses. Prosthet Orthot Int. 2005;29(1):27-37. http://doi.org/cfkpz6.

Datta D, Vaidya SK, Howitt J, Gopalan L. Outcome of fitting an ICEROSS prosthesis: views of trans-tibial amputees. Prosthet Orthot Int. 1996;20(2):111-5.

Sanders JE, Nicholson BS, Zachariah SG, Cassisi DV, Karchin A, Fergason JR. Testing of elastomeric liners used in limb prosthetics: classification of 15 products by mechanical performance. J Rehabil Res Dev. 2004;41(2):175-86. http://doi.org/cpbfn8.

Gailey R, Allen K, Castles J, Kucharik J, Roeder M. Review of secondary physical conditions associated with lower-limb amputation and long-term prosthesis use. J Rehabil Res Dev. 2008;45(1):15-29. http://doi.org/brqr39.

Murley GS, Landorf KB, Menz HB, Bird AR. Effect of foot posture, foot orthoses and footwear on lower limb muscle activity during walking and running: a systematic review. Gait Posture. 2009;29(2):172-87. http://doi.org/ddmmx3.

Latlief G, Elnitsky C, Hart-Hughes S, Phillips SL, Adams-Koss L, Kent R, et al. Patient Safety in the Rehabilitation of the Adult with an Amputation. Phys Med Rehabil Clin N Am. 2012;23(2):377-92. http://doi.org/f3z9cf.

Boer J, Nazary M, Riis PT. The Role of Mechanical Stress in Hidradenitis Suppurativa. Dermatol Clin. 2016;34(1):37-43. http://doi.org/cv7f.

Dudek NL, Marks MB, Marshall SC, Chardon JP. Dermatologic conditions associated with use of a lower-extremity prosthesis. Arch Phys Med Rehabil. 2005;86(4):659-63. http://doi.org/bvx8q5.

May BJ, Lockard MA. Prosthetics & Orthotics in Clinical Practice: A Case Study Approach. Philadelphia: F.A Davis; 2011.

Sbano P, Miracco C, Risulo M, Fimiani M. Acroangiodermatitis (pseudo-Kaposi sarcoma) associated with verrucous hyperplasia induced by suction-socket lower limb prosthesis. J Cutan Pathol. 2005;32(6):429-32. http://doi.org/cftpkc.

Hachisuka K, Nakamura T, Ohmine S, Shitama H, Shinkoda K. Hygiene problems of residual limb and silicone liners in transtibial amputees wearing the total surface bearing socket. Arch Phys Med Rehabil. 2001;82(9):1286-90. http://doi.org/bdd5ht.

Lusardi MM, Jorge M, Nielsen CC. Orthotics and Prosthetics in Rehabilitation. 3rd ed. St. Louis, Missouri: Elsevier Saunders; 2013 [cited 2018 Oct 24]. Available from: https://goo.gl/Dqhwug.

Murphy DP. Fundamentals of Amputation Care and Prosthetics. New York: Demos Medical Publishing; 2013 [cited 2018 Oct 24]. Available from: https://goo.gl/9t4Vq8.

Meulenbelt HEJ. Skin problems of the stump in lower limb amputees. Groningen: University of Groningen; 2010.

Diseases and Conditions Staph infections. Scottsdale: Mayo Clinic Staff; 2016 [cited 2016 Nov 16]. Available from: https://goo.gl/CJ3MXP.

Minnesota Department of Health. Causes and Symptoms of Staphylococcus aureus. Minnesota Department of Health; 2010 [cited 2018 Oct 24]. Available from: https://goo.gl/DBYPDT.

Healthline. Candida Fungus Skin Infection. New York: The Healthline Editorial; 2016 [cited 2016 Nov 16]. Available from: https://goo.gl/uPRFUb.

Pillenger J. Infection of the skin by Candida albicans (cutaneous candidiasis). London: Netdoctor; 2013 [cited 2016 Nov 16]. Available from: https://goo.gl/P5HhsT.

Hall MJ, Shurr DG, VanBeek MJ, Zimmerman MB. The Prevalence of Dermatological Problems for Transtibial Amputees Using a Roll-on Liner. J Prosthetics Orthot. 2008;20(4):134-9. http://doi.org/d3gpcw.

Dillingham TR, Pezzin LE, MacKenzie EJ, Burgess AR. Use and satisfaction with prosthetic devices among persons with trauma-related amputations: a long-term outcome study. Am J Phys Med Rehabil. 2001;80(8):563-71. http://doi.org/dsvjjb.

Hagberg K, Brånemark R. Consequences of non-vascular trans-femoral amputation: a survey of quality of life, prosthetic use and problems. Prosthet Orthot Int. 2001;25(3):186-94. http://doi.org/cft6td.

Meulenbelt HE, Geertzen JH, Jonkman MF, Dijkstra PU. Determinants of Skin Problems of the Stump in Lower-Limb Amputees. Arch Phys Med Rehabil. 2009;90(1):74-81. http://doi.org/c2ft4c.

Ghoseiri K, Bahramian H. User satisfaction with orthotic and prosthetic devices and services of a single clinic. Disabil Rehabil. 2012;34(15):1328-32. http://doi.org/fx496v.

Quintero-Quiroz C, Jaramillo-Zapata A, De Ossa-Jiménez MT, Villegas-Bolaños PA. Estudio descriptivo de condiciones del muñón en personas usuarias de prótesis de miembros inferiores. Rev Colomb Med Física y Rehabil. 2015;25(2):94-103. http://doi.org/cv7g.

Dudek N, Marks MB, Marshall SC. Skin Problems in an Amputee Clinic. Am J Phys Med Rehabil. 2006;85(5):424-9. http://doi.org/fc8xr7.