Infection in the residual stump is a common problem amongst amputees, and can result in the need for additional treatment, with periods out of the prothesis, or in the very worst cases additional surgery and shortening of the limb.

For insurers defending personal injury claims, this has the potential to increase costs, not only due to the additional treatment, but the setbacks it can cause the claimant and therefore delays to resolution of the claim.

A prosthetic joint infection is the result of bacteria, most often Staphylococcus aureua and Staphylococcus epidermidis which is always almost present in the human body and as prosthetic devices can be worn for lengthy periods, it gives the bacteria an opportunity to grow on the joint.

A study carried out by a research team in Europe investigated the impact of different prosthetic and orthotics material on bacterial adhesion, “To better understand the bacterial adhesion, the surface topography, roughness, hydrophobicity, and zeta potential of all materials under consideration were measured.“

The study found that the level of bacterial adhesion on the prosthetic increased as the surface roughness of the prosthetic increased. For example material including thermos cork and artificial leather were more likely to be become infected.

Ethylene- vinyl acetate was the least likely to have bacterial growth. Ethylene- vinyl acetate is traditionally a very soft plastic, which is lightweight, easily moulded and crack and impact resistant. It is widely used on for inner liners, boots and the orthotics of the hand and wrist.

The study also revealed that cracks, grooves, dimples within the surface of the material were most likely to encourage bacterial growth. Thermos cork and leather are more rigid, with higher absorbency and therefore more likely to attract infection.

These results would undoubtedly assist prosthetists and rehabilitation experts in amputation claims to not only select the most appropriate device for a claimant but also assist in measuring and mitigating the risk of infection. Minimising the occurrence of infections will reduce claim costs and life cycles for insurer.

Mandeep Chahal-Dhillon is a member of Clyde & Co’s Amputation Subject Matter Group.