Satisfaction and problems experienced with transfemoral suspension systems: a comparison between common suction socket and seal-in liner.

OBJECTIVE To compare a seal-in liner with the common suction socket with regards to patient satisfaction and problems experienced with the prosthesis. DESIGN Retrospective survey. SETTING A medical and engineering research center and a department of biomechanical engineering. PARTICIPANTS Men (N=90) with traumatic transfemoral amputation who used both suspension systems participated in the study. INTERVENTION Two prosthetic suspension systems: a seal-in liner and common suction socket. MAIN OUTCOME MEASURES Two questionnaires were completed by each subject to evaluate their satisfaction and problems experienced with the 2 suspension systems. Satisfaction and problems with the prosthetic suspension systems were analyzed in terms of fitting, donning and doffing, sitting, walking, stair negotiation, appearance, sweating, wounds, pain, irritation, pistoning, edema, smell, sound, and durability. RESULTS The study revealed that the respondents were more satisfied with a seal-in liner with regards to fitting, sitting, and donning and doffing. Overall satisfaction increased with the use of a seal-in liner compared with the suction socket (P<.05). However, satisfaction with the prosthesis showed no significant differences in terms of walking (flat and uneven surfaces), appearance, and stair negotiation. Furthermore, problems experienced differed significantly between the 2 suspension systems (P<.05). Sweating, wounds, pain, irritation, pistoning, edema, smell, and sound were less problematic with the use of a seal-in liner, whereas durability was significantly better with the suction socket. CONCLUSIONS The results of the survey suggest that satisfaction and problems with prosthetic suspension in persons with transfemoral amputation can be improved with a seal-in liner compared with the suction socket, provided that the durability of the liner is enhanced.