Diabetes Infection

Print Email Share

Wound Care: Preventing Infection

After your surgery, attention focuses on care of the wound and maintenance of the residual limb.

Any wound from amputation or other surgery is at risk of becoming infected because the skin opening can allow germs or dirt to enter the bloodstream. Infections can cause soreness or pain, fever, redness, swelling, or discharge. These infections can also lead to further complications, surgery, or even death if not treated properly.

While you are in the hospital, it is mainly the job of the healthcare workers to care for your wound. Even so, the more you know about what is happening, the better you will be able to take care of yourself once you leave the hospital.

You will always need to pay special attention to the hygiene of your residual limb. Since it spends most of its time enclosed in the socket or liner of your prosthesis, it is more prone to skin breakdown and infection.

If you suspect you are getting an infection, contact your doctor immediately! Act quickly, before a small irritation becomes a serious problem.

REMEMBER: The best way to handle an infection is to PREVENT it! Here are a few guidelines for taking care of the residual limb

• Wash your residual limb with mild soap and water, then rinse and pat dry. Do this at least once a day; do it more often if you sweat a lot or are treating a rash or infection.
• Wash anything that comes into contact with your skin (liners, socks, inner socket, etc.) with mild soap and water, then rinse and dry.
• Do not use alcohol-based lotions on your skin. They cause the skin to dry and crack, increasing the chance of infection.
• Do not use too much softening lotion; use just enough to prevent dry skin.
• Maintain a good prosthetic fit at all times and take care to maintain correct alignment and socket fit. Having the right fit will help relieve pressure spots and soreness.
• Eat a balanced diet and drink plenty of water to maintain supple, healthy skin.
• If you are a diabetic, monitor and maintain your glucose levels.

Following are some common problems that can happen even if you take the above precautions. Possible treatments are also listed but, remember, see your prosthetist or doctor if the problem persists!

Problem: A red or sore area that does not go away when prosthesis is off.
Treatment: Check prosthetic fit before the red area becomes an abrasion.

Problem: A blister caused by pressure between the socket/liner and the skin.
Treatment: Check prosthetic fit. Do not burst a blister; cover with a very thin sterile dressing. If the blister opens on its own, put antibiotic ointment on the area and cover it.

Bacterial infections can cause major problems if they go untreated, so alert your prosthetist or doctor if you have any of these symptoms. They are listed in order of severity:

• area around the wound feels hot
• area becomes red and swollen
• pus or white/yellow drainage
• sudden increase in pain
• severe tenderness
• fever

Any of the following signs require EMERGENCY attention to prevent the infection from spreading to your entire body and endangering your life:

• circulation decreases; the extremity feels cold
• wound smells bad
• swollen glands in groin or armpits
• wound has thick, brown/gray discharge
• skin around the wound turns black or gangrenous

Follow your doctor’s instructions carefully and maintain good hygiene for the following conditions. If you are taking antibiotics, always finish up the prescription even if the infection seems to have cleared up.

Problem: Allergic reaction (itchy rash or swelling).
Treatment: If the rash is mild, it may help to put an antihistamine cream on it. Make sure liners and socks are rinsed well after washing. Seek medical advice if the problem persists.

Problem: Fungal infection (itchy, burning rash similar to athlete’s foot).
Treatment: Topical antifungal creams or diaper cream may work. Seek medical advice if the problem does not go away.

Problem: Verrucose hyperplasia or thickened, red area on end of the residual limb. This is caused by a lack of total contact between the residual limb and the socket.
Treatment: Check the fit of your socket and seek medical advice to treat skin.

REMEMBER

• Removing the cause and treating the problem go hand in hand. If you are a diabetic, or have vascular disease, it is important that you watch your limb and seek medical and prosthetic advice if you have an opening in the skin. If you catch a problem early and take care, you will often be able to continue to wear your prosthesis while healing.
• Swelling will stretch your skin, making it easier to break or tear. While the wound of your amputation surgery is still fresh, keep pressure on your residual limb by wrapping with an elastic bandage, wearing a shrinker, or wearing your Immediate Post-op or temporary prosthesis. Also, keep the limb elevated whenever possible.
• Take care of your whole self: body, mind and spirit. Eat well and drink plenty of water to strengthen your body’s own natural healing abilities.
• Check your residual limb regularly for signs of breakdown or infection. When you see a sign of infection, even a small one, act quickly.

Reprinted with permission of the Amputee Coalition of America.