Through trial and error, we have found that external compression is the best method of treatment, in combination with adequate control of any bacterial infection or ulceration. Using plastics or foam-rubber cushions, a temporary buildup of the distal socket wall can be achieved for better support of the residual limb. Once adequate support of the stump end is provided, the skin condition gradually disappears and does not recur. The greater the compression on the distal stump skin, the more immediate and lasting the improvement. In many instances, the socket must be redesigned to allow for sufficient backpressure on the tissues at the end of the stump.
Malignant degeneration can occur and has been seen in three instances by the author.
Early diagnosis and treatment is therefore of utmost importance. In some amputees, the sockets are redesigned for total contact. Contact dermatitis and eczematization of the amputation stump skin have been seen in a small number of patients. Varnishes, lacquers, various plastics, and resins may be used in finishing the socket of the leg prosthesis. We have learned that such materials are capable of producing primary irritation or true allergic sensitization.