Skin adaptation in lower limb amputees assessed through Raman spectroscopy and mechanical characterization.

Area of Science:

• Biomedical Engineering
• Dermatology
• Biomechanics

Background:

• Residual limb skin in lower limb amputees is non-weight-bearing leg skin.
• Prosthetic sockets require this skin to bear significant loads.
• Existing hypotheses suggest adaptive changes in amputee skin with prosthesis use.

Purpose of the Study:

• To investigate the adaptive capacity of lower limb amputee skin under mechanical load.
• To determine if repeated frictional trauma leads to beneficial load-bearing adaptations.
• To evaluate changes in skin barrier function, inflammation, friction, and stiffness.

Main Methods:

• Confocal Raman spectroscopy
• Mechanical characterization
• Cytokine analysis

Main Results:

• Amputee skin adaptations resulted in impaired barrier function.
• Increased baseline inflammation, higher coefficient of friction, and reduced stiffness were observed.
• Repeated frictional trauma did not confer beneficial load-bearing adaptations.

Conclusions:

• Non-plantar skin, unlike plantar skin, may lack the biological capacity for positive adaptation to repeated mechanical trauma.
• Current therapies focusing on mechanical conditioning or product solutions are insufficient for improving load-bearing capacity.
• Multiscale analysis of skin tribology is crucial for developing effective interventions for lower limb amputees.