I have used a lot of different liners over the years, in fact I’ve a box in the garage full of them and these two, the Iceross® Sport & the Iceross Dermo® Locking I would say are the best of the lot.
I personally wear the sport liner but it does have its drawbacks, this is why I’m writing about my favourite two. For the record I use a different liner for diving but I will leave that for another day to write about.
Heat & Comfort
So why do I use a pin liner? One reason is layers, I mean why would you wear a jumper and a fleece when its 35 degrees? You simply wouldn’t and that’s what I find with some suspension sleeves. If you going somewhere hot you want as few layers as possible covering your stump and if you use a pin liner your stump will be encased in a socket and a 3 mm thick silicone liner. At the end of the day you have to have something covering your stump to hold on the leg! Beaning hot is an issue you must always consider when selecting a liner.
Just to get my point across in this matter I even refuse to wear black sockets, they are absolutely the worst socket colour to use as it absorbs the heat very quickly and your stump can feel like it’s cooking inside the liner. I made this mistake In Egypt one year and it was an absolute nightmare, I vowed never to wear a black socket in the heat again!
I personally always get my sockets made white or reflective these days and believe me when I say it makes a substantial difference to how much heat the sockets absorb so I would strongly recommend that you have your sockets white if you like the heat!
When you use seal in liners they can be problematic, or at least they are for me. Even if you have a seal in liner that is setup to have minimum layers i.e. no external sleeve going over the knee, you are relying on the seal to keep the leg attached to you. I have worn various types and makes of Vacuum/seal in liners and to put it bluntly every single one has failed! Which is not good if you want to disappear into the wilds for six months!
Here’s some more examples, two weeks in Grand Cayman the heat made the seal very soft and within a few days the seal was constantly breaking and the leg would drop off, if I wore the external sleeve it was just so uncomfortable with the heat and the bunching behind the knee made things rather sore in that area too.
The liners without the pin can be more difficult to line up and get on in a hurry especially with sweaty hands. I’ve even had to resort to dragging it on like a sock which is not good for the skin as I could not grip the liner. I resorted to using duct tape to keep the dam thing attached for the flight home and vowed never to try that again.
I’ve worn them in the sea and when the water gets in the seal breaks, the leg ends up relying on the external sleeve to stay attached I ended up just sort of towing the leg behind me
I have even tried diving with a vacuum pump which was a fantastically bad idea and won’t be trying that again so seal in liners, vacuum liners etc are just not suitable for what I like to do, but that is not to say they will not work with your lifestyle. They may be suitable for you as there is some advantages to them and if you do wear one and you want to go to the tropics a Proximal Lock would be an absolute must!
Safety & Confidence
Yes, that’s right safety! A leg that falls off is simply not safe nor does it install confidence. I also have had the seal break dangling my legs out of a loft hatch as I was swinging my foot into the hatch as I was getting out, almost clonking my mate on the head as it fell. We still laugh about that one and it has actually happened twice!
My personal view is you need to have a secondary form of suspension such as a pin or a Proximal Lock. If you have this set up in place there would be very little chance of your leg dropping off which also gives you confidence it won’t do so.
I would go as far as to say that if you were thinking of going to locations where I go to on my wanderers then your prosthetic must have some form of mechanical suspension, it’s just not worth not having it. I can almost guarantee you will have issues if you don’t.
There is a drawback to the pin setup, in that with your traditional locks the air can get in at the bottom which also means water can get in! Also because the liner in a sense is suspended by the pin to some extent this causes a mild milking or pistoning of the liner which will milk the liner off your stump particular in the heat.
This is remedied by using an air tight lock so the leg is effectively held on by suction which is not unlike the seal in liners and the pin is basically a backup should the limb become loose due to the activity you are doing or volume fluctuations which can occur.
One of the best things about an airtight lock is that when you need the leg to be very well attached i.e. for running or walking a long distance you can use a thin airtight external sleeve which essentially makes the pin liner become more like a vacuum seal which is extra secure when you need it to be. When you are seated or just moving around not so much you just pull back the external sleeve reducing the layers and making it far more comfortable for low demanding tasks.
This is why I use pins with an airtight lock and I genuinely believe that’s the best setup for someone like me.
So back to the liners and why I have picked two, I have used both liners extensively over the years. The dermo liner I would say it is probably the more comfortable of the two in particular when the liner is new. It has a coating of aloe Vera which is a little greasy when new but that soon goes and the liner becomes tackier.
It easier to get on and off compared to the sport liner and requires no lining up. I didn’t get any skin problems with this one and I would say it’s a very good general purpose liner and probably a more suitable liner for most people. That said it’s not my first choice.
The sport liner is what I use these days and again this liner is also recommended by Donald Kerr. He issues these to his patients if they are suitable for them. They are very tacky on the skin from the beginning and feel very well attached but at first they are not as comfortable as the Dermo liner but when they’re broken in, which takes a month or so the comfort increases. So for me it’s worth it due to how stable they are.
The Sport liner needs to be put on in a particular way and they have to be lined up when you put them on. I personally put a permeant marker line on the inside to make it easier for me when fitting the liner. It’s rather tight and if you have weak hand strength it may not be suitable which is where the Dermo liner is good.
It also very good staying in place and not rotating which can be an issue for some people, as was for me. A rotation injury can be very debilitating and even make waring a leg impossible until you are healed. I have not had a rotation injury since using one of these and it’s one of the reasons why I really like this liner.
Another tip for fitting the Sport liner in fact all the liners that I have used is that you cut the top of the liner with a wave or bevel with a straight cut it can create a line or ridge against the skin which will become sore. If you have that problem try cutting the top of the liner in an irregular way which generally will solve that problem, isn’t common sense a marvellous thing!
If it comfort that’s more important to you then the Dermo liner it is, but if you want the security and you’re willing to sacrifice a little comfort then the sport liner is the choice. I go for the sports liner as it fits my needs.
Oh and on another note both these liners are very durable I have done hundreds of dives using these types of liners and they last very well unlike others so in the longer term they are good value for money.