From the FDA Drug Label
Apply Urea 40% to affected skin twice per day, or as directed by your physician. Rub in until completely absorbed. The best prescription cream for skin breakdown at BKA prosthesis site is Urea 40% cream, to be applied to the affected skin twice per day, or as directed by a physician 1.
- Key considerations:
- Apply to affected skin
- Follow physician directions
- Monitor for redness or irritation and discontinue use if it occurs 1
From the Research
For skin breakdown at a below-knee amputation (BKA) prosthesis site, I recommend using a cream that combines hyaluronic acid and silver sulfadiazine, as it has been shown to be effective in improving wound healing and reducing bacterial load 2. This approach is supported by a recent study that demonstrated the combined action of hyaluronic acid and silver sulfadiazine is clinically effective in improving wound healing, with a significant reduction in the inflammatory process and bacterial load 2. Key considerations for managing skin breakdown at a BKA prosthesis site include:
- Reducing inflammation and irritation
- Preventing infection
- Promoting a moist environment to enhance wound healing
- Addressing underlying mechanical issues, such as ensuring a proper fit of the prosthesis socket and reducing wear time Some studies suggest that silver sulfadiazine may be effective in preventing infections in uncomplicated soft-tissue wounds 3, and a comparative study found that silver dressings and dressings without silver may have better results than silver sulfadiazine for wound healing 4. However, the most recent and highest-quality study 2 supports the use of a combination of hyaluronic acid and silver sulfadiazine for wound healing and management of bacterial biofilm, making it the preferred choice for skin breakdown at a BKA prosthesis site. It is essential to clean the affected area gently with mild soap and water before applying any medication and to allow the skin to fully dry. If the breakdown doesn't improve within 7-10 days, or if there are signs of worsening infection, seek prompt medical attention as stronger prescription options or systemic treatments may be needed.