Satisfaction with cosmesis and priorities for cosmesis design reported by lower limb amputees in the United Kingdom

BACKGROUND: Amputee satisfaction with cosmesis and the importance they place on cosmesis design have not been published in the literature. OBJECTIVES: To investigate the current satisfaction levels of amputees in the United Kingdom with their cosmesis and the importance placed on attributes of cosmesis design to inform future cosmesis redesign. STUDY DESIGN: Cross-sectional questionnaire study. METHODS: Questionnaires were administered to lower limb amputees in the United Kingdom. Satisfaction scores and the overall importance ranking of cosmesis features were calculated. Statistically significant relationships between two demographic, satisfaction or importance variables were tested using Fisher's exact tests (one-tailed) at a significance level p = 0.05. RESULTS: Between 49% and 64% of respondents reported neutral or dissatisfied opinions with the cosmesis features (greater than 50% for five of the nine features). The three most important features identified were shape matching the cosmesis to the sound limb, free prosthetic joint movement underneath the cosmesis and natural fit of clothing over the cosmesis. CONCLUSIONS: The results indicate that current cosmesis satisfaction levels of amputees in the United Kingdom are below what the medical device industry and clinical community would desire. The most important cosmesis features identified by the sample can be used to direct future cosmesis design research. CLINICAL RELEVANCE: The findings will enable the medical device industry to improve cosmesis design in the areas that are important to amputees. The findings also counter anecdotal opinions held by clinicians, providing an opportunity for them to evaluate any preconceptions they harbour and how this might influence their clinical work.