Late Breaking News
Stump Dermatoses Still Plague Vietnam War Amputees
- Categorized in: July 2013
BETHESDA, MD - Nearly four decades after a major-limb amputation, nearly half of Vietnam War veterans reported they continue to suffer stump dermatoses, according to a recent study from the Uniformed Services University of the Health Sciences.1
“More than 38 years after major-limb amputation, skin complications at the stump site continue to cause significant morbidities and contribute to prosthesis abandonment,” wrote the authors of the report, which appeared in JAMA Dermatology. “The high prevalence of stump dermatoses stresses the importance of disease prevention, early management and advanced treatment of skin disease.”
For the study, researchers recruited 416 men with combat-related limb loss from the Indiana-Ohio Center for Traumatic Amputation Rehabilitation Research registry from 2006-2009. Of that group, 247, a 59.3% response rate, completed a self-reported 35-item health and demographic questionnaire, then responded to a follow-up survey on long-term health and psychosocial issues associated with their amputations by telephone, online or mail.
The survey respondents — average age, 62 years; 91.9% white — reported that 38 years was the average time since war-related amputation, with unilateral lower limb the most common level of amputation (61.9%), followed by bilateral lower extremity loss (21.9%).
Most, 150 respondents (61.5%) reported pain or discomfort at the stump site.
Among the survey-takers, 119 (48.2%) reported at least one skin problem in the preceding year, including skin breakdown (25.2%), rash (21.8%) and abrasion or “rubbing off” of skin (21%).
Of the veterans experiencing skin problems, 25.2% reported such problems more than 50% of the time, and 5.9% experienced those problems all the time within the preceding year.
Stump dermatoses also affected prosthetic usage, with 64 respondents (55.6%) reporting skin problems at their stump site that limited or prevented them from using their prosthesis for an average of 28 days in the preceding year. Another 43 men (37.1%) had to alter or replace their prosthesis because of skin problems.
“The finding in this study … demonstrates that there is limited natural adaptation of the stump skin to the prosthesis over time,” the researchers said. “Stump dermatoses will be a lifelong health problem and financial burden for an amputee if more permanent interventions are not found.”
1. Yang NB, Garza LA, Foote CE, Kang S, Meyerle JH. High prevalence of stump
dermatoses 38 years or more after amputation. Arch Dermatol.
2012 Nov 1;148(11):1283-6. doi: 10.1001/archdermatol.2012.3004.
PubMed PMID: 23165833.