An orthopedic or prosthetic support including at least three layers that allows for aeration and cushioning of the enclosed area is described herein. The orthopedic or prosthetic support includes an inner cushioning layer which is compressed against the skin in use. An intermediate scaffolding layer is situated substantially parallel to the inner cushioning layer and is maintained in spaced apart relationship with the inner cushioning layer by spacer members. An exterior layer overlays the intermediate scaffolding layer and may be either a flexible breathable fabric such as velvet or a thermoplastic with a plurality of perforations. The inner cushioning layer and the intermediate scaffolding layer include a plurality of perforations providing air pathways through the two layers. The grid-like arrangement of spacer members also define air passages between the inner and intermediate layers which further enhance circulation of exterior air to the skin covered by the orthopedic or prosthetic support.