Socket Comfort

The Basics

Prosthetic liner as an adhesive system

The materials silicone and TPE gel have a particularly good adhesion or adhesive effect on the skin with a high coefficient of friction - TPE gel even has flow properties to optimally cushion and embed particularly sensitive areas such as the edge of the tibia, the head of the fibula or the distal end of the residual limb.

Textile covers are either sewn from bi-elastic woven fabric in liner form or produced as a circular knitted tube. Their function is to secure the silicone or TPE gel layer to the outside. In this way, it is possible to turn the liner inside out so that the prosthetic liner can be unrolled over the limb stump.

The attachment to the leg or arm prosthesis is done mechanically via a metal pin and a latching system that is integrated in the prosthesis shaft. Other technical fastening options are retraction systems by means of a so-called cord-lock or vacuum socket technology (VST), in which ejection valves are used.

The Advantages

Everything you need to know about the silicone and gel liner range:

wide range of silicone and gel liners, knee caps, residual limb socks and care accessories
first-class materials: medical grade silicone and polymer gels with skin-caring and antibacterial properties
high wearing comfort due to especially soft padded liner ends
new design and circular knitting technique with functional areas
easy handling when turning the liner inside out; the coloured orientation line makes it easier to put on the liner correctly; the functional knitted fabric is smooth and robust on the outside
integrated function: the knitted-in longitudinal traction inhibitor reduces the so-called suction/pumping or milking effect between the skin and the liner or to the prosthetic socket
new, soft rotation caps at the end of the liner support the guidance of the leg prosthesis and make it easier for the orthopaedic technician to take the plaster cast and the subsequent modelling
more product safety due to stitched-in serial numbers

The Product Names

Valuable help for technicians and patients

„Basic“: liner models that have 3 mm silicone or TPE gel in the area of the middle wall thickness. The cushioning layer is thicker at the distal end of the liner to provide good cushioning for the sensitive end of the residual limb.

„Soft“: designation of silicone and gel liners with a mean wall thickness of 6 mm; however, in the case of gel liners, only the front end has 6 mm of padding - this padding layer protects the sensitive areas at the tibial edge.

„Soft+“: this name identifies a particularly strong padding layer on the gel liners. Here, a 9 mm thick gel layer protects the particularly sensitive areas of the bony shinbone edge.

„Control“: a particularly hard-wearing silicone in the "AK-ControlSil." thigh liner models and the "Control4Sil.basic" and "Control4Sil.conic" sealing lip liners.

The Mobility Level

Liners for every activity level (Walky)

If the leg prosthesis is only used indoors or as a transfer aid, we speak of low-activity users. In this case, the prosthesis liner has the task of fastening the leg prosthesis securely to the leg without it slipping off the leg stump during mobilisation. In order to make even difficult residual limbs prosthesis-compatible, heavily padded liner models are often used.

For medium activity levels, gel and silicone liners are usually used to make wearing the prosthetic leg comfortable for limited and unrestricted outdoor walkers.

For outdoor walkers with particularly high demands, silicone liners are used without exception, as this material is extremely durable.

FAQ

Hygiene and proper cleansing - this means that before using the liner or knee cap for the first time, the inside must be thoroughly washed with 30° C warm water and 10H2 Skin-Care cleansing lotion. In this way, hygiene is increased to the maximum and any excessive stickiness of the silicone or TPE gel inside is reduced. This is important because a certain amount of acclimatisation takes place when changing a liner model.

What is important to remember when using a liner or knee cap for the first time?

After use, the liner or knee cap is thoroughly cleaned and placed on the drying stand provided. This allows the silicone or gel inside to dry completely.

After the daily cleaning of the liner, the residual limb skin must also be washed and - if it feels dry afterwards - moisturised with the 10H4 Skin-Care moisturising lotion. The moisturising lotion from Streifeneder ortho.production soothes stressed residual limb skin.

Particularly stressed skin areas can also be protected with 10H3 Skin-Care Cream.

The liner or knee cap must be disinfected on a weekly basis. With the 10H5 Skin-Care dressing spray, the silicone or gel liner is sprayed with 2 - 3 strokes and finally wiped with a soft and clean cloth.

Which precautions should be taken when using liners or knee caps on a daily basis?

The silicone or gel liner must be cut straight or diagonally with corrugated scissors. Please do not cut the silicone or gel liner anatomically, because this can overstretch individual areas at the edge of the liner and lead to premature wear of the liner.

How should the liner or knee cap be cut?

1. Incorrect cut: see above - one of the most frequent reasons for complaints.

2. Incorrect choice of model: e.g. if the activity level is too high. Gel liners in particular are intended for rather low walky classes in order to embed sensitive leg stumps. If the activity level is too high, the liner material can wear out prematurely, but also the muscle force transferred by the user is absorbed by the soft liner material.

3. Incorrect size: e.g. too wide or too tight. Due to the size run, attention must be paid to the correct liner size. With silicone liners, the residual limb circumference must be measured approx. 4 cm above the distal tip of the residual limb in a circular fashion. For initial fittings, the size equal to the measured residual limb circumference is often used, for subsequent fittings use one size smaller. Two circular residual limb measurements are necessary to determine the size of gel liners. One is taken at the distal end of the residual limb, about 4 cm above the tip of the residual limb, and the second is taken about 30 cm from the distal end of the residual limb.

Generally, experience is required when determining the size, as a liner that is chosen too narrow can be very uncomfortable or even painful for the amputee. If the liner size is too wide, air may be trapped, which leads to increased sweating at the end of the residual limb. The body sweat that builds up reacts aggressively to the residual limb skin and in combination with pressure and friction can lead to further residual limb skin problems.

4. Incorrect or improper tightening of a liner. Each silicone or gel liner must be turned completely inside out, centred on the distal end of the residual limb and unrolled slowly. When the liner is unrolled at the level of the knee, it is advisable to slightly flex the knee to minimise contact pressure on prominent kneecaps. Removal is done in reverse order.

5. Incorrect cleaning or disinfection not only leads to possible skin problems, but can also change the material composition in the silicone or TPE gel. The consequences are known to be premature wear, brittleness, cracking or a decrease in the cushioning effect of the liner material.

What should definitely not be done when using a liner or knee cap?