Cosmetic solutions for lower limb prosthetics

Uvod: Amputacija je odstranitev dela okončine s poškodbo, boleznijo ali operacijo. Operativna odstranitev se uporablja za obvladovanje bolečine ali preprečitev širjenja bolezni na prizadeti okončini, kot sta rak in gangrena. V nekaterih primerih se za takšne probleme izvede tudi preventivna operacija. Posebni primeri so kongenitalne amputacije, kongenitalne motnje, kjer so bile prizadete zarodkove okončine. Amputacija spodnje okončine je ena izmed najstarejših znanih operacij, kjer začetki segajo nazaj v prazgodovino. Nožna proteza je izdelana individualno za specifično osebo. Medtem ko so nekatere proteze izdelane samo glede na funkcijo, veliko amputirancev želi takšno protezo, ki je izdelana iz materialov, ki so podobni človeški koži in izgledajo čim bolj podobno pravi nogi. Kozmetika proteze je umetnost, pri kateri je cilj napraviti umetni ud čimbolj realističen. Namen: Namen diplomskega dela je pregled literature na področju kozmetike protez spodnjih okončin. Metode dela: Diplomsko delo je zasnovano na deskriptivni metodi dela. Zbrali smo tujo in domačo literaturo, jo med seboj primerjali in na podlagi dobljenih rezultatov zapisali pomembnejše ugotovitve. Literaturo smo poiskali s pomočjo bibliografske baze PubMed (Medline) in iskalnika Google učenjak. Rezultati: Rezultati kažejo, da je trenutno zadovoljstvo amputirancev s protetičnimi kozmetikami nižje, kot bi si medicinska in klinična skupnost želeli. S testiranjem protez s kozmetiko in mnenjem medicinske stroke so raziskovalci dokazali, da je pri novem dizajnu izboljšana vzdržljivost. Zaradi te vzdržljivosti je trajanje uporabe novih protez tudi do trikrat daljše kot čas uporabe standardne kozmetike. Zaradi kompleksnosti dizajna se podaljša čas izdelave, kar bi lahko vodilo v daljši prvi obisk, namenjen pomerjanju proteze. Bolj vzdržljiva kozmetika pa omogoča manj obiskov pacientov pri specialistih. Razprava in zaključek: Zunanji izgled je v današnji družbi visoko cenjen, zato izguba okončine negativno vpliva na posameznikovo samopodobo. Pri amputirancih spodnjih okončin lahko kozmetične prevleke izboljšajo lastno percepcijo in družbeno sprejemanje osebe z amputacijo, zato kozmetične prevleke pozitivno vplivajo na posameznikovo telesno samopodobo. Kozmetika pa ni samo estetski dodatek k protezi, vključuje namreč tudi funkcionalni vidik. Pri strokovni izdelavi kozmetika zmanjšuje poškodbe in okvare na protezi oz. njenih komponentah, ki so posledica vsakodnevne uporabe, nepazljivosti ali malomarnosti. Protetična kozmetika tudi pomaga, da se oblačila ne zatikajo za komponente proteze in da se na njih ne nabirajo prašni delci, ki bi dolgoročno lahko škodovali gibljivosti proteze, s tem pa se olajša tudi čiščenje proteze.Introduction: Amputation is the removal of part of a limb by trauma, illness, or surgery. Surgery is used to control pain or to prevent illness or infection such as cancer or gangrene from spreading on an impaired limb. In some cases, preventive surgery is needed for such problems. Special cases include congenital amputations and congenital disorders, where the fetus’s limbs were affected. Lower limb amputations are one of the oldest known surgeries, dating back to prehistoric times. A leg prosthesis is made individually for a specific person. Some prostheses are made only for functional purposes, but many amputees want a prosthesis that visually resembles a real leg as much as possible, and is made of materials similar to human skin. The process of making a cosmesis is a form of art which pursues the goal of making an artificial limb as real-looking as possible. Purpose: Little research has been done about the importance of cosmesis features among amputees all around the world. Therefore, I decided to research this topic and interpret the results to everyone who is in any way related to prosthetics. My goal is to remind manufacturers of prosthetics of the importance of customising cosmesis to customers, because in my home country, Slovenia, this aspect of manufacturing an artificial limb is rather overlooked. We neglect in particular its functionality, even though the development of this particular feature has spread widely all over the world. Methods: The diploma thesis is based on a descriptive method. I collected Slovenian and foreign literature and compared it. Using my own estimation, I selected the sources of literature that are worth mentioning. I sourced most of the literature from the PubMed (Medline) browser, Google Scholar, and other scientific browsers. Results: The results show that current satisfaction of amputees with prosthetic cosmesis is lower than medical and clinical employees would want it to be. The most important cosmesis features indicated in the questionnaire can be used for further research. By testing prostheses with cosmesis and considering the opinion of medical professionals, the researchers have shown that the new design provides greater durability (the new cosmesis lasts up to three times longer than the standard cosmesis). Because the design is more complicated, the manufacturing time is longer, and that could potentially cause a longer first appointment dedicated to fitting the cosmesis, in comparison with the standard cosmesis design. A more durable cosmesis means fewer appointments with doctors. Discussion and conclusion: Appearance is highly regarded in today’s society, therefore limb loss is considered to be something negative or shameworthy. It has a negative impact on an amputee’s self-esteem. In lower extremity amputation, cosmetic covers can contribute to a better appearance, and consequently increase the patient’s self-respect, self-confidence, and overall self-esteem. All this proves that prosthetic cosmesis is more than just an aesthetic accessory to the prosthetics. It has a huge functional role as well. It protects prosthetic components from damage or malfunctioning, as a result of everyday use of prosthetics, sloppiness, or lack of care. It prevents clothes from getting caught between prosthetic components, or dust from collecting on components, which could potentially lead to less flexibility. A cosmesis cover also makes it easier to maintain a clean artificial limb, and contributes to improving gait and posture (it prevents the lower part of the spine from getting damaged)