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Gwen

Pin or harmony system for BKA with skin graft

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I've been an amputee for 20 years. In the last 3 years, I've had a lot of issues with my prosthesis. I have a skin graft and I get wounds/skin breakdowns frequently. I've mostly used the pin system since my amputation.

I'm wondering which system would be the best for me. I'm a BK amputee. I've been told that either the pin system (with a good socket fit)or the vacuum system (Harmony) could be the answer to my problems. However, I'm confused which one of these systems I should go for. My main goal is to walk with no pain and not have skin breakdowns. Does anyone else on this forum also have a skin graft? If so, which system do you wear and are you happy with it?

Thanks!

Gwen

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Hi Gwen ....i am also b k and have a skin graft so know the issues. I suppose yr options really depend on the size and position of your graft and what you have tried already. I spent many yrs using a no 8 type leg with thigh corset as stump cld not tolerate any pressure my graft was on the front, underneath and part way at back of stump. But about 3 yrs ago i had a revision and reconstruction and now just really have grafting on the front and now wear a regular PTB type with a quite thick Alpha liner wch works well.

I tried both pin and harmony previous to the revision, neitherworked for me at the time, but i know the pin can pull on the end of the stump whichfor me isthe area my graft meets the reconstriucted bit so personally wld pass on that, the harmony also puts pressure on the entire stump and though i know ppl who love it, there is a lot of pressure from the suction which seems to make the stmp appear more reduced, so again for me personally, another option i wld pass on.

Your situation cld be entirely different from mine though Gwen and you need to find out what works for you. Make sure you check what areas you will be taking weight on, possible friction areas, prob most importantly material of the liner you will use as some materials are kinder to the skin than others.

Wish you well with it all.

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What Ann says makes sense. Tell your legman you want to try different systems. If he is unwilling to do this, try another legman. It is your longterm comfort and health that is important here. He can make suggestions, but only you know what works best.

I don't have a skin graft, but cannot wear the pin system because of the pulling on the end of the stump. I've never used the Harmony system, but have used a vacuum system. I liked the way it made the leg feel like it was really part of me, but I didn't like the way it kept it's tight fit while sitting. It all boils down to the fact that no one system is good for all of us.

I've been using Ossur's Seal-in X5 liner for the past 4 years and love it. It has the convenience of a pin system without the pulling and yet the snug fit I like as in the vacuum without that tight fit of a vacuum. It works quite well for me.

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What Neal says about 'tightness' could be an issue with a graft, I tend to like my sockets with extra sock room, anything tight especially on the grafted side will aggravate the skin, as my skin graft doesn't 'give' in the same way my normal skin does ... but having said that I have been living and more importantly walking with prosthetics (most of the time)with a skin graft for over forty years, so it is all do-able, one way or other.

What works for me at the moment is an ordinary PTB with soft bottomed Alpha liner, I do sometimes have problems but its more often to do with the socket not fitting right, or sweating, it also has its disadvantages such as 'bulk' behind the knee which limits the knee bending, but for me that's not too big a trade-off, and keeps me walking b/k.

Apologies about spelling, as was sending other posting from phone.

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Thanks Ann and Neal for answering my post! It's helpful. If someone else on this forum also has a skin graft at the bottom of the stump, it would be great if you could let me know which system (pin or vacuum) you use.

Thanks!

Gwen

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Hi Gwen,

I am very new to the Harmony system. Only three weeks so far. I do have a lot of skin graft under the stump and up to the knee cap on my left leg. So far it is working out very well.

Let me know if I can answer questions better.

Doug

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I am about the try out the new P3 Harmony system which is supposed to be a bit lighter, does anyone have experience with this please? I originally tried the pin lock system but it caused discomfort in the distal area of the stump during swing phase especially. I am wondering if the vacuum assisted socket has a bit of this effect also. I love to walk but the changing pressures with each step make me very aware of having a prosthetic and the discomfort it causes. I wonder, does this change with time? I am a one year accident victim.

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Hi Edwina, I haven't tried the new P3 Harmony, but know someone who uses that system (though probably not the new P3) and who gets on really well with it.

I think there are quite a few of us who can't tolerate the pin lock system, but I think a lot of the discomforts we experience are often down to how well the socket actually fits us, and I don't really think time makes a lot of difference. I am currently over forty years as an amp, and if I get something that fits me properly then things are really good and I get very little discomfort, but if a socket is not fitting properly I get all manner of problems, how I walk, if I walk, and how much discomfort I have can change overnight with a bad fitting socket.

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I've tried both...I was started off by my first prosthetist in a pin system and was in almost constant pain...turns out my vascular problem was made even worse by the pin system that he tried to make work for 2 years. Switched to vacuum system and it is perfect...what a difference. Ann is right, a bad fitting socket will never work with any system.

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I'm currently in a harmony for 1 out of 5 days so far, don't know if it's the liner but I can hardly bend my knee when walking like I'm getting kick back. Go back Friday and see what can be done. If not I'm goin back to a pin lock with alpha hybrid. Those liners feel so much better than any I've tried. They made my pin lick with an iceros which for me was very uncomfortable. I tried it with my alpha hybrid and got a world of difference

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I couldn't use a pin lock, tried a check socket once, and it hurt to even stand on it, thats when i went to the Harmony. I'm right now having some stress issue, skin "splitting" on distal end like I had with old PTB's. I am beginning to think it's inside the liner, because putting a ball of clay in the bottom of my socket, shows I'm going in all the way.

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