Adaptive Wound Care in Lower Extremity Amputation: From Rehabilitation to Athletic Performance

Lower extremity amputation remains a significant clinical challenge, most commonly resulting from diabetes mellitus and peripheral arterial disease, and is associated with high morbidity and mortality. This review briefly summarizes the burden of lower extremity amputation and then focuses on individuals with transtibial amputation who use a prosthesis, with particular attention to residual limb health. Advances in prosthetic technology have improved functional outcomes and quality of life, enabling many individuals to achieve ambulation and, in some cases, return to high levels of physical activity. However, increased prosthetic use introduces unique challenges related to skin integrity, including friction, moisture, and pressure-related injuries within the prosthetic socket. These risks may be amplified in athletes with limb loss, who are exposed to higher mechanical and metabolic demands. This review introduces the concept of adaptive wound care, which emphasizes prevention, early detection, and management of residual limb skin complications in both general and athletic prosthesis users. Common injuries, including friction and shear injuries, pressure injuries, moisture-associated skin damage, folliculitis, contact dermatitis, volume-related injuries, and sport-related trauma, are described along with strategies for their prevention and treatment. Integrating surgical, prosthetic, rehabilitation, and wound care principles is essential to optimize outcomes, enhance function, and reduce complications following lower extremity amputation.