Donning and Doffing Your Upper Limb Prosthesis
by Lauren Trent, MOT, OTR/L, on Jan 4, 2021
Donning and doffing are the words used to describe the process of putting on (donning) and the process of taking off (doffing) a prosthetic device. Donning and doffing look very different depending on what type of device someone has. It may take just a few seconds to fasten the straps on a partial finger device, or it may take several minutes or more for those with higher level or bilateral limb differences. No matter what level, there are steps that should be taken before donning and after doffing a prosthesis to make sure that the residual limb is cared for and the device is kept in the best possible shape.
Before donning your prosthesis, please be sure that the socket or liner is clean and has been dried well. The next step depends on which method is being used to assist with donning a prosthesis: wet fit, dry fit or nothing added during donning process. Wet fit refers to adding a lubricant (typically hand sanitizer) to either the residual limb or to the donning sock/pull sock. Dry fit refers to adding powder (baby powder is one option) to the pull sock before donning. Most of our partial finger/hand difference patients use wet fit without a pull sock, while higher levels (wrist or higher) use the dry or nothing-added-to-the-pull-sock method. There are some cases where a patient may choose to utilize a wet fit with the pull sock (lubricant either on the pull sock or on the residual limb, or both). Lastly, there are cases where a liner is used and neither wet nor dry methods are necessary (the liner is just rolled on and the prosthesis is pulled on over the liner).
The device should provide some resistance when donning — if the process is too easy, that may indicate that the socket is too loose and won’t be able to suspend securely while it is worn, or a loose fit may result in inconsistent function. If it is particularly difficult to get on, that can indicate that the prosthesis is too tight, resulting in potential discomfort while wearing, as well as issues with consistent function. Please keep in mind that in the first several months (or sometimes years), residual limbs can change in size and you may need to visit your prosthetist to receive a new or adjusted socket. Custom-made silicone sockets can help with a difficult fit.
For some types of prosthesis, one adaptation that can make a device easier to don and doff is the BOA system (see the wheel in the picture below). The BOA system is a patented system first developed as a shoe lacing system that allows the wearer to tighten or loosen the shoe while wearing it. Stainless steel wires are connected to the turning knob to allow for that tightening. On a prosthetic device, it can be used to quickly tighten or loosen the fit of the prosthesis. The system may or may not be available to your particular prosthetic provider, but you can learn more about it in our article about increasing the wear time of your prosthetic device.
To doff your prosthesis, make sure to be in a comfortable space where the device can be cleaned soon after it is removed. Carefully loosen the skin of the residual limb as you slowly work your limb out of the socket. Some patients choose to add lubricant to the residual limb to assist with this process. Be sure to clean your prosthesis after doffing. We have an article about how to clean your device in our article about daily care of your prosthesis.
Your prosthetist and therapist should walk you through all the steps of donning and doffing of your device to ensure that you are comfortable with the process. Our Arm Dynamics clinicans make sure this happens for all of our patients before they take their prosthesis home. We aim for independence with donning and doffing to make sure you are able to wear your prosthesis as much (or as little) as you want to.
Below, you can find a video of Jason Koger donning his prosthetic devices:
Do you have any tips or tricks about how to don or doff your device? Or do you think you can don or doff it (safely) in record time? Tell us more in the comments. If you are interested in learning more about how you can receive a prosthesis, or how you can upgrade your current device, please contact us. We look forward to hearing from you!
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