Skin care is a critical issue for wearers of orthoses and prostheses, and the most common complaints include odor, moisture and bacteria build-up and skin irritation.

“We have a lot of kids with dermatological problems, such as contact dermatitis and other similar conditions that are common for us because of the climate here in the South,” Justina Shipley, CO, MEd, FAAOP, director of orthotics and prosthetics at Shriners Hospital for Children in Shreveport, La., told O&P Business News. “As a result we were interested in finding something that would be effective in helping to alleviate a lot of those problems.”

Silver-based fabrics, which can deliver antimicrobial benefits, is one option for battling skin irritation and breakdown caused by orthotic and prosthetic devices.

“We used them sporadically, but the medical staff wanted to see some clinical evidence before we invested in something that they would prescribe to put on the kids,” Shipley said.

Clinical testing

Shipley and her colleagues recruited 13 patients from Shriners Hospital who wore an ankle-foot orthosis (AFO) for 10 or more hours per day. All of the patients experienced visible skin irritation or breakdown resulting from AFO wear.

Each patient was given socks impregnated with silver fibers (SilverMax AFO Liner Sock, Comfort Products Inc.) and asked to wear the socks continuously for 4 weeks. The patients’ parents were instructed on how to properly care for the socks as well as for their child’s skin. Shipley said she uses Comfort Products socks exclusively.


Justina Shipley


After 4 weeks, all of the study participants showed significant improvements, including a reduction in redness and improvements in irritation caused by dermatitis, eczema, athlete’s foot and insect bites, among others.

“We had chronic irritation with eczema, athlete’s feet and insect bites, and they were cleared after 29 days to 34 days if they wore the socks consistently,” Shipley said. “We expected them to work, but we didn’t expect them to work as well as they did.”

Benefits of silver

The socks used in the study were powered by X-STATIC antimicrobial technology, which is made by Noble Biomaterials Inc.
X-STATIC fibers are bonded with 99.9% pure metallic silver through a proprietary process that creates a thin coating of silver on the surface of the textile and allows for 100% surface coverage.

“Silver in its non-ionized form is inert, but contact with moisture leads to the release of silver ions,” Karin Mueller, MA, director of marketing for Noble Biomaterials, told O&P Business News. “When this happens, the positively charged silver ions are attracted to negatively charged bacteria.”

The charged silver ions then combine with the bacterial cells, attacking the DNA of the bacteria and inhibiting it from mutating and reproducing.

“X-STATIC enhances soft surface textiles with continuous and permanent antimicrobial protection by creating an ionic shield that inhibits the growth of odor-causing bacteria directly on the surface of fabrics,” Mueller said. “X-STATIC also provides natural temperature regulating properties, reflecting heat back to keep you warm and evaporating moisture faster to keep you cool.”

The X-STATIC fibers, which are approved by the FDA and the Environmental Protection Agency, “provide a quick, comprehensive and continuous release of these silver ions for the life of the product,” Mueller added.

According to Mueller, third-party clinical testing has also demonstrated that fabrics that incorporate X-STATIC technology are safe for use.

“We have used several hundred pairs of socks, and so far, we haven’t had any problems,” Shipley added. “And we have not seen any adverse effects at all.”

Shipley and her colleagues now also fit silver-based stump socks and spinal orthosis interfaces in addition to AFO socks.

“The benefits that we have seen have been enough to continue to have the medical staff prescribe them to a lot of our patients,” Shipley said.

They hope to continue their research with silver-based fabrics to assess the long-term benefits of this technology.

“We want to continue our research by also implementing a follow-up survey to the parents or patients who have been wearing these socks for 2 years to 3 years,” Shipley said. “We want to do the follow-up survey to see what their opinion is about the socks and the benefits that they have seen from long-term wear.”

Shipley presented the results of this study during a technical workshop at the American Academy of Orthotists and Prosthetists Annual Meeting in Orlando, Fla. The workshop, which was sponsored by Comfort Products Inc., addressed common skin-related issues caused by prosthetic and orthotic devices and how silver-based fabrics can help mitigate these complications. — by Megan Gilbride

For more information:

Shipley J. Treatment of patients with compromised skin using silver-based fabrics. Presented at: American Academy of Orthotists and Prosthetists Annual Meeting and Scientific Symposium. Feb. 20-23, 2013. Orlando, Fla.

Disclosure: Shipley has no relevant financial disclosures. Mueller is employed by Noble Biomaterials Inc., which manufactures X-STATIC silver products.

Disclosure: O&P Business News does not endorse any company or products mentioned herein. Not all companies or products relevant to the topic are represented.

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