INTRODUCTION
Prosthetic-using amputees are particularly susceptible to skin irritation and infection. The closed, warm, moist environment at the liner-skin interface encourages bacterial and fungal growth and the release of by-products within the prosthetic socket, which increase the likelihood of local skin breakdown, irritation, inflammation and potential for infection of the residual limb. Unlike the skin of palms and soles, the altered skin of a patient’s residual limb is not physiologically adapted to withstand the repetitive pressure, shear force, and compressive friction that results from patient ambulation. This compromised condition of the skin can be exacerbated by inherent scars, invaginations, and bony protrusions left from the amputation procedure. These issues are combined with the disturbance to the patient’s vasculature and lymphatic system, and compromise the residual limb’s local immune system (Buikema, 2014). Among this patient population, microbialrelated complication is common, as 74% of prostheticbearing amputees report some sort of residual limb skin disease following amputation, ranging from mild dermatitis to antibiotic-resistant bacterial infection (Wanivenhaus, 2016). Skin cultures of amputees who utilize a prosthetic device show an altered bacterial flora with both a heightened colonization and stronger virulence of strain-type (Köhler, 1989).

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