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Veterans report stump dermatoses almost 40 years after amputation

Almost half of Vietnam War veterans who completed a survey reported stump dermatoses at least 38 years after major limb amputation, according to study results.

Researchers recruited 416 men from the Indiana-Ohio Center for Traumatic Amputation Rehabilitation Research veteran registry who sustained combat-related limb loss. Participants were recruited from 2006 to 2009, and completed self-reported 35-item health and demographic questionnaires. A follow-up survey on long-term health and psychosocial issues associated with their amputations was administered by telephone, online or by mail.

Two hundred forty-seven men (mean age, 62 years; 91.9% white) completed the survey (59.3% response rate). Thirty-eight years was the average time since war-related amputation. Unilateral lower limb was the most common level of amputation (61.9%), followed by bilateral lower extremity loss (21.9%). One hundred nineteen patients (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. Sixty-four men (55.6%) reported 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. Forty-three men (37.1%) had to alter or replace their prosthesis because of skin problems. One hundred fifty men (61.5%) reported pain or discomfort at the stump site.

“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.

“The high prevalence of stump dermatoses stresses the importance of disease prevention, early management and advance treatment of skin disease.”