PMC10443507_01
The condition of the Case #1 patient's residual limb (a) before being fitted with a perforated liner and (b) after three months of use.
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PMC10443507_01_cpoj.v2i1.32723-fig001.jpg
F1
Blisters would develop in and around the scars at the distal end of his residuum, where sweat collected (Figure 1a). There was a review appointment after three months in September 2017, at which time the patient was regularly going for 8km jogs, the blistering had healed (Figure 1b) and he had cancelled the surgery.
PMC10443507_02
The condition of the Case #2 patient's residual limb (a) approximately one year before being fitted with a perforated liner, (b) at the point of fitting, and after (c) 4 weeks of use, (d) 7 weeks of use (the point of changing to passive vacuum suspension), (e) 9 weeks of use, (f) 11 weeks of use and (g) 13 weeks of use.
cpoj.v2i1.32723-fig002.jpg
PMC10443507_02_cpoj.v2i1.32723-fig002.jpg
F2
An ulcer developed on the posterior-distal aspect of his residuum (Figure 2a) and it worsened to the extent that his doctor had mentioned the possibility of further amputation to a trans-femoral level. The ulcer had persisted for over a year before he was initially fitted with a locking, perforated liner on 27th August 2018 (Figure 2b). When asked what the dermatology clinic advised him, the patient explained "they said the white heavy skin that look like a callous around the wound (Figure 2b), was from moisture. When compared to the initial fitting stage (Figure 2b), at 4 weeks (24th September 2018 - Figure 2c), the ulcer had visibly reduced in size and the wound was no longer suppurating. At 7 weeks (15th October 2018 - Figure 2d), Tissue was granulating and the affected area/ulcer had reduced in size. Over the following 6 weeks, the ulcer reduced in size considerably (1st and 12th November 2018 - Figure 2e and f), before being considered fully healed 13 weeks after initial fitting (28th November 2018 - Figure 2g).
PMC10443507_03
The condition of the Case #3 patient's residual limb (a) in its worst condition in 2011, (b) in 2013 and (c) in March 2019, after continued use of a perforated liner (since 2016) with elevated vacuum suspension and hydraulic ankle (since August 2017).
cpoj.v2i1.32723-fig003.jpg
PMC10443507_03_cpoj.v2i1.32723-fig003.jpg
F3
Excessive perspiration had led to the skin becoming macerated and infected (Figure 3a and b). The patient has continued to use this prescription for over a year, during which time his residuum remains in good health (Figure 3c).