Determinants of Skin Problems of the Stump in Lower-Limb Amputees
Abstract
Meulenbelt HE, Geertzen JH, Jonkman MF, Dijkstra PU. Determinants of skin problems of the stump in lower-limb amputees.
Objective
To identify determinants of skin problems in lower-limb amputees.
Design
Survey, using a questionnaire.
Setting
Not applicable.
Participants
Lower-limb amputees (N=2039) who either obtained their prosthesis through the Orthopedische Instrument Makerij (a group of orthopedic workshops in the Netherlands) or were a member of the (Dutch) National Society of Amputees (Landelijke Vereniging van Geamputeerden) were invited to participate. In total, 872 lower-limb amputees agreed to participate.
Intervention
Amputees filled in the questionnaire to assess characteristics of the amputation and prosthesis, level of activity, stump and prosthesis hygiene, and skin problems. Stepwise backward logistic regression was performed to analyze determinants of skin problems.
Main Outcome Measure
Skin problems in the month prior to completing the questionnaire.
Results
A total of 816 questionnaires were received. Eventually 805 questionnaires were suitable for statistical analysis. Protective determinants were (in order of magnitude of association) older age, male sex, and amputation because of peripheral arterial disease and/or diabetes. Provocative determinants were (in order of magnitude of association) use of antibacterial soap, smoking, and washing the stump 4 times a week or more often. In total, 63% of the participants (95% confidence interval, 60%–67%) reported 1 or more skin problems.
Conclusions
The provocative determinants identified in this study—use of antibacterial soap, smoking, and stump washing frequency—have to be studied for their clinical relevance.
aCenter for Rehabilitation, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
bGraduate School for Health Research, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
cDepartment of Dermatology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
dDepartment of Oral and Maxillofacial Surgery, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
Reprint requests to Henk E. Meulenbelt, MD, Center for Rehabilitation, University Medical Center Groningen, University of Groningen, Hanzeplein 1, PO Box 30.001, 9700 RB Groningen, The Netherlands
No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit on the authors or on any organization with which the authors are associated.
ABSTRACT