Silcare Breathe Cushion Liner

PDAC Approved
Activity Level 3 (4)

Optimal control of a prosthetic limb depends on a comfortable and secure connection between limb and socket. Modern liner technology provides excellent cushioning, but the impermeable and insulating materials can allow a build-up of heat and moisture so they begin to slip and chafe. Air, perspiration and unnecessary movement can cause a loss of connection, compromised stability and damage to residual skin, potentially affecting mobility, safety and independence.

The patented technology of Silcare Breathe works by letting the air and perspiration that are often trapped between the liner and skin to escape through specially designed laser drilled perforations.  The air and moisture are then expelled from the socket as the wearer walks, resulting in drier skin and a healthier environment for the residual limb.  This helps to increase comfort and control, and reduce the damaging effects of relative motion on damp tissues that is often encountered with standard prosthetic liners.

Key Benefits

Silcare Breathe Technology

The body cools by moving blood flow closer to the surface of the skin, and when this is not sufficient the body produces sweat to increase cooling by evaporation.

The need to regulate body temperature is greater for amputees, and a lack of temperature regulation can have severe negative effects.

Benefits of breathable liner technology

The Silcare Breathe range has been designed to tackle these issues. Laser drilled perforations transmit moisture away from the skin to ensure a comfortable, cool and secure fit for the user.

  • Reduced relative movement between the residual limb and liner
  • Enhanced proprioception
  • Enhanced comfort
  • Drier, cooler, healthier skin

1 Seymour,R. Prosthetics and Orthotics: Lower Limb and Spinal. Philadelphia: Lippincott, Williams and Wilkins 2002,
2 Hagberg K, Brånemark R. Consequences of non-vascular trans-femoral amputation: a survey of quality of life, prosthetic use and problems. Prosthetics and Orthotics International. 2001; 25(3):186-94.
3 Peery JT, Ledoux WR, Klute GK. Residual-limb skin temperature in transtibial sockets. Journal of Rehabilitation Research & Development. 2005; 42(2):147-54.

Testimonials

Clinical Evidence

Researchers at Blatchford in the US and UK have recently published a report evaluating the outcomes of three patients with residual limb skin problems, when they switched from their previous prescriptions to perforated Silcare Breathe liners.

All of the cases experienced a substantial reduction in sweating on their residual limb and their skin problems resolve – some in as little as three months. The improved environment within the prosthetic socket allowed them to wear their limbs unaffected by the issues that had previously caused them to restrict activities and prosthetic limb use.

View the paper “The influence of perforated prosthetic liners on residual limb wound healing: a case report”.

Silcare Breathe Cushion Liner Clinical Evidence Reference

Clinical Outcomes using Sweat Management liners

  • Improvements in residual limb health problems and wound healing1,2
  • Fewer residual skin issues2
  • Reduction in pain in residual and phantom limb2
  • Improved heat dissipation compared to other temperature regulation solutions3
  • Removes sweat from skin interface1,2,4
  • Perforations do not damage the skin4
  • Patients reported a preference for their perforated liners1,4
  • Reduces the need to remove prosthesis throughout the day to dry residual limb4

There are two published literature reviews that discuss different aspects of lower limb prosthetic liner technology5,6.

  • The main purpose of prosthetic liners is to cushion the transfer of loads from the prosthetic socket to the residual limb5.
  • Based on load-displacement data from the compressive stiffness tests, silicone was one of three materials that were recommended for situations where it is desirable for the liner to maintain thickness and volume since these materials had the least non-recovered strain5,7.
  • Under cyclic compressive loading, silicone was one of two materials that had the greatest cycles to failure under compressive loading, while the Pedilin and polyurethane samples lasted orders of magnitude less5,8.
  • Prosthetic liners and sockets are highly resistive to heat conduction and could be a major contributor to elevated skin temperatures5,9.
  • There are reduced residual limb pressures with the silicone liner compared to other conditions (no liner; soft inserts) suggesting that silicone has an ability to distribute pressure evenly to the residual limb4,10.
  • In terms of patient outcomes, there was no clear preference between silicone and Pelite liners5,11.

References

1. McGrath M, McCarthy J, Gallego A, et al. The influence of perforated prosthetic liners on residual limb wound healing: a case report. Can Prosthet Orthot J 2019; 2(1)
2. Davies KC, McGrath M, Stenson A, Savage Z, Moser D, Zahedi S. Using perforated liners to combat the detrimental effects of excessive sweating in lower limb prosthesis users. Can Prosthet Orthot J. 2020;3(2).
3. Williams RJ, Washington ED, Miodownik M, et al. The effect of liner design and materials selection on prosthesis interface heat dissipation. Prosthet Orthot Int 2018; 42: 275–279.
4. Caldwell R, Fatone S. Technique for perforating a prosthetic liner to expel sweat. JPO J Prosthet Orthot 2017; 29: 145–147.
5. Klute GK, Glaister BC, Berge JS. Prosthetic liners for lower limb amputees: a review of the literature. Prosthet Orthot Int 2010; 34: 146–153.
6. Richardson A, Dillon MP. User experience of transtibial prosthetic liners: a systematic review. Prosthet Orthot Int 2017; 41: 6–18.
7. Sanders JE, Greve JM, Mitchell SB, et al. Material properties of commonly-used interface materials and their static coefficients of friction with skin and socks. J Rehabil Res Dev 1998; 35: 161–176.
8. Emrich R, Slater K. Comparative analysis of below-knee prosthetic socket liner materials. J Med Eng Technol 1998; 22: 94–98.
9. Klute GK, Rowe GI, Mamishev AV, et al. The thermal conductivity of prosthetic sockets and liners. Prosthet Orthot Int 2007; 31: 292–299.
10. Sonck WA, Cockrell JL, Koepke GH. Effect of liner materials on interface pressures in below-knee prostheses. Arch Phys Med Rehabil 1970; 51: 666.
11. Lee WC, Zhang M, Mak AF. Regional differences in pain threshold and tolerance of the transtibial residual limb: including the effects of age and interface material. Arch Phys Med Rehabil 2005; 86: 641–649.

See all the Clinical Evidence for every Blatchford product in our Clinical Evidence Finder Tool.

Silcare Breathe Cushion Liner Technical Data

Amputation Level:

Trans-tibial

Activity Level:

3-4

Sizes Available:

22, 23.5, 25, 26.5, 28, 30, 32, 34, 36, 40

Ordering

Example

SB TT CP/LP XX L
  Trans-tibial Cushion/Locking Parallel Size Light Tone

Note: 23.5 = 23 and 26.5 = 26