Today, people have several choices when selecting a cosmetic cover for their prosthetic hand and arm. These range from durable vinyl production gloves to realistic high-definition custom silicone cosmetic covers. Traditionally, prosthetic gloves were offered in relatively low-definition PVC material with a limited range of colors. These production gloves gave the prosthesis a more natural appearance and provided protection for the components against moisture and dirt. Unfortunately, there is no standard for cosmetic colors, so each supplier has its own collection of skin colors. Prosthetists can obtain color swatches from the supplier and match these as best they can to the user's skin tone. Due to the limited number of colors, this process does not assure a perfect color match.

 

Manufacturers began offering various vinyl compounds to improve durability, stain resistance and appearance. Silicone was also introduced as an alternative to PVC. Silicone is not more durable, but it resists stains better than PVC and since cosmetic gloves are frequently exposed to newsprint and other common household materials, the silicone alternative is typically more appealing to many patients.

 

The most advanced cosmetic covers are custom high-definition silicone. These match the size, shape and features of the individual's sound-side limb in every detail. A mold is taken of the sound-side limb and used as an anatomical model to craft a matching cover. To assure proper color match, photographs or digital images of the user's hands are normally taken against a background template. These images are re-calibrated by the silicone facility using a graphics color-matching system. Artists and technicians then use this information to produce a realistic cosmetic cover to place over the prosthesis.

 

Superior Orthotics and Prosthetics uses a spectrometer manufactured by Konica Minolta. This device accurately reads the color tones in the patient's skin. This process offers the most life like prosthetic device and covers while eliminating human error in interpretation of the photos.

 

There are two methods for manufacturing these high-definition silicone covers; creating a clear shell with a painted interior surface or, blending pigment into the silicone. Painting the interior surface has been used for a number of years, but more recently a new process has started blending color into silicone. This provides a durable surface because the color is uniform throughout and it produces natural "depth" of the skin surface.

 

High-definition covers can be supplied with extraordinary detail such as freckles, veins, special skin pigmentation, human hair and even tattoos if necessary. Females may want to apply nail enamel to their finger nails and this can be accomplished by substituting acrylic for the silicone nails normally supplied with these covers. The goal is to match the unaffected limb as closely as possible for a natural look. One of the limitations however, is that people's skin color changes seasonally with exposure to the sun and with certain activities that bring more blood to the surface of the extremities. Therefore, users must have realistic expectations regarding cosmetic covers for their prosthesis.

 

In addition to complete prosthetic covers, the custom high-definition silicone process is also suitable for partial hand restorations. Individual and multiple finger restorations are produced with amazing results. Individual fingers normally have a feathered edge to blend with the interface to the hand. These are normally attached through a suction fit. Partial hands are fit to the residual limb on a glove with holes for the remaining fingers. Watches and rings can be used to conceal joints and to draw attention away from the cosmesis itself.

 

High-definition custom covers are time consuming to make and therefore are considerably more costly than off-the-shelf production gloves. Production gloves cost a few hundred dollars whereas custom high-definition silicone gloves cost thousands. But if appearance is critical, there is no comparison. Because of the cost, people should treat these as they would their own hands. Any of these covers can be damaged. Contact with harsh chemicals, abrasive surfaces, sharp objects and fluids that stain should be avoided. When appropriate, rubber or work type gloves should be worn to protect the cosmetic cover as one would protect the natural hand.

 

Contact Superior Orthotics and Prosthetics with questions or comments concerning prosthetic covers and prosthetic restorations. Superior offers nine patient care locations in Middle Tennessee, call 615-340-0068 to schedule an in-service or appointment.