Bacterial comparison study of prosthetic liners

Amputee patients in low-resource settings face a heightened risk of skin infections at the skin-liner interface of their residual limb, which can develop into a variety of serious complications. Most research comparing prosthetic liners has focused on mechanical and aesthetic properties. However, the relative propensity of different liner types to host bacterial growth has yet to be explored.

To address this question, we performed a bacterial comparison study across a traditional sock-EVA combination liner, an advanced Ossur Iceross silicone liner, and a novel silicone liner designed for low-resource hospitals in developing nations. We cultured Staphylococcus aureus within a novel physical model of the skin-liner interface, incorporating a replicate skin layer suspended over a self-regulating heat source. After culturing bacteria for 24 h, we collected and quantified cells in solution.

Statistical analysis of the bacterial growth concentration from 9 trials revealed relative consistency of growth across the 3 liner types, suggesting that none of the liners pose heightened risks of infection, relative to the others.

These results suggest that certain innovative prosthetic materials may safely be considered for fabrication of prosthetic liners in low-resource environments. The in vitro skin-liner model and test method for bacterial growth characterization introduced herein may be useful for future dermatological simulations.