Fungal colonisation in digital silicone rubber prostheses

The fungal discolouration of silicone rubber prostheses is reported in four cases. In two of the cases, the discolouration was caused by the fungus Candida tropicalis. In the other two cases, two different fungal organisms, namely Trichoderma sp. and Scedosporium prolificans were incriminated. The non-porous silicone rubber layers create an enclosed environment in the suction cup of the prosthesis and preclude ventilation at the prosthesis-stump interface. The moisture as a result of sweat and body warmth in the stump assists fungal growth. Residual salts from the sweat, sebum from sebaceous glands and the residues from petroleum jelly (Vaseline) applied to facilitate donning, can adhere to the surfaces of the prosthesis and provide the nutrients for fungal growth. Prolonged continuous usages of the prosthesis, the presence of sweaty palms in the users, donning the prosthesis during manual physical activities which induce perspiration, washing of hands with the prosthesis on and warm humid climatic conditions have been identified as factors predisposing the prosthesis to fungal colonisation. The fungal growth caused a black discolouration and marred the aesthetic quality of the prostheses. As a preventative measure, daily immersion of the prostheses in denture cleaner such as benzalkonium chloride, or water at 60 degrees C for 15 minutes, or decontamination with 70% alcohol is recommended. Prior cleaning to remove organic matter before decontamination is emphasised.