Non-removable cast heals diabetic foot ulcers

For diabetic patients with foot ulcers, wrapping a standard removable cast walker with a cohesive bandage improves compliance with the device and the proportion of ulcers that heal and the rate of healing, researchers report.

Wounds don't heal very well with removable devices "because they are...removable," Dr. David G. Armstrong told AMN Health.

In fact, he and his colleagues found that "people with wide open wounds on the bottom of their feet were only wearing their devices for an average of 28 percent of the steps they took each day."

"We postulated that the reason these removable devices weren't working was because they weren't being worn," he explained. So his team developed the "instant total contact cast" or iTCC. It's basically a removable cast walker wrapped with a cohesive or plaster bandage making it tough to take off.

They randomly assigned 50 diabetics with foot ulcers to the standard removable cast walker or the non-removable iTCC. At 12 weeks, a higher number of patients had foot ulcers healed in the iTCC group than in the removable cast group.

Also, patients in the iTCC group healed significantly sooner than those in the other group. This "simple modification can dramatically improve healing over standard devices," Armstrong, of Rosalind Franklin University of Medicine and Science, North Chicago, Illinois, concludes.

SOURCE: Diabetes Care March 2005.