Skin adaptation in lower limb amputees assessed through Raman spectroscopy and mechanical characterization
File(s)
Published version
Author(s)
Type
Journal Article
Abstract
Following lower limb amputation residuum skin from the lower leg is used to reconstruct the residual limb. Unlike skin on the sole of the foot (plantar skin), leg skin is not inherently load bearing. Despite this, leg skin is required to be load bearing in the prosthetic socket. Current hypotheses propose that lower limb amputee skin can adapt to become load bearing with repeated prosthesis use. Here, we show using confocal Raman spectroscopy, mechanical characterization and cytokine analysis that adaptations occur which actually result in impaired barrier function, higher baseline inflammation, increased coefficient of friction and reduced stiffness. Our results demonstrate that repeated frictional trauma does not confer beneficial adaptations in amputee skin. We hypothesize that non-plantar skin lacks the biological capabilities to respond positively to repeated mechanical trauma in the same manner observed in plantar skin. This finding highlights the need for improved therapies as opposed to current mechanical conditioning or product solutions that directly relate to improving load-bearing capacity on the skin of lower limb amputees. This study also highlights the importance of measuring multiple parameters of application-specific skin at different scales for skin tribology applications.
Date Issued
2025-01-08
Date Acceptance
2024-11-19
Citation
Journal of the Royal Society Interface, 2025, 22 (222)
ISSN
1742-5689
Publisher
The Royal Society
Journal / Book Title
Journal of the Royal Society Interface
Volume
22
Issue
222
Copyright Statement
© 2025 The Authors. Published by the Royal Society under the terms of the Creative Commons Attribution License http://creativecommons.org/licenses/by/4.0/, which permits unrestricted use, provided the original author and source are credited
License URL
Identifier
https://www.ncbi.nlm.nih.gov/pubmed/39772735
Subjects
confocal Raman spectroscopy
DAMAGE
DECREASE
friction
indentation
INDIVIDUALS
inflammation
LIPIDS
Multidisciplinary Sciences
PRESSURE
Science & Technology
Science & Technology - Other Topics
SHEAR
skin surface
stratum corneum
STRATUM-CORNEUM THICKNESS
STRESS
STUMP
WATER CONCENTRATION PROFILES
Publication Status
Published
Coverage Spatial
England
Article Number
20240475
Date Publish Online
2025-01-01