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  • Title: [The value of total contact casting in treatment of neuropathic foot ulcers in diabetic patients].
    Author: Dzieciuchowicz L, Checiński P, Waliszewski K, Zapalski S.
    Journal: Pol Merkur Lekarski; 1997 Sep; 3(15):132-4. PubMed ID: 9461711.
    Abstract:
    Neuropathic foot ulcers in diabetic patients pose great difficulties in treatment. Total contact casting is one of the available methods. It is thought to distribute the pressure evenly over the entire surface of the foot. The purpose of the study was the evaluation of the total contact casting as a method of treatment of neuropathic foot ulcers in diabetic patients. Ten diabetic patients with neuropathic foot ulcers were treated with total contact casting. The inclusion criteria were good arterial blood supply and the absence of bone, joints or surrounding soft tissue infection. The mean area of the ulcers was 1.9 cm2 (1.3-3.6 cm2). The average duration of the ulcer prior to commencement of the treatment was 10 months. Total contact cast was applied after thorough surgical debridement and covering of the ulcer with occlusive dressing. The casts were changed every six to ten days. The ulcers healed in 9 out of 10 treated patients. The healing time averaged two months. In one patient development of soft tissue infection necessitated discontinuation of the treatment and performing open ray amputation. In four patients superficial ulcerations of the skin of the dorsal aspect of the toes developed. They resulted in prolonged duration of the treatment. Total contact casting in adequately qualified and reliable patients is safe and effective method of treatment of neuropathic foot ulcers in diabetes.
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