2014, Number 1
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Gac Med Mex 2014; 150 (1)
The gold standard in diabetic foot treatment: total contact cast
Lozano-Platonoff A, Mejía-Mendoza MDF, Ibáñez-Doria M, Contreras-Ruiz J
Language: Spanish
References: 67
Page: 58-64
PDF size: 357.35 Kb.
ABSTRACT
In patients with diabetes, foot complications remain one of the main health issues, with ulcers representing one of the most
common. These ulcerations originate from repetitive trauma on a foot with neuropathy. Inadequate care of the diabetic
foot may lead to one of the gravest complications of the diabetic foot: amputation.
The key to the treatment of the diabetic foot is the control of comorbidities (glucose levels and vascular disease),
debridement, exudate control with the available modern dressings, treatment of infection, and offloading the affected foot.
A common error in this basic treatment is the method used for offloading, leading to delayed healing as a result, and
maybe even amputation. For this purpose we propose the total contact cast considered the “gold standard” in diabetic
foot offloading.
The objective of the present review is to present the existing evidence in the medical literature on the effectiveness of
its use for healing diabetic foot ulcers and hence preventing amputations.
REFERENCES
Wild S, Roglic G, Green A, Sicree R, King H. Global Prevalence of diabetes. Estimates for the year 2000 and projections for 2030. Diabetes Care. 2004;27(5):1047-53.
International Diabetes Federation. IDF Diabetes Atlas, 5th ed. Brussels, Belgium: International Diabetes Federation, 2011.
Boulton J, Kirsner S, Vileikyte L. Neuropathic diabetic foot ulcers. N Eng J Med. 2004;351:48-55.
Boulton A. The diabetic foot: a global view. Diabetes Metab Res Rev. 2000;16:2-5.
Irkovska A. Care of patients with the diabetic foot syndrome based on an international consensus. Cas Lek Cesk. 2001;140(8):230-3.
Mayfield J, Reiber G, Sanders L, Janisse D, Pogach L. Technical Review: Preventive foot care in people with diabetes. Diabetes Care. 1998;21:2161-77.
Got I. Necessary multidisciplinary management of diabetic foot. J Mal Vasc. 2001;26:130-4.
ADA. Consensus Development Conference on Diabetic Foot Wound Care. Diabetes Care. 1999;22:1354-60.
Boulton A, Armstrong D. Trials in neuropathic foot ulceration. Diabetes Care. 2003;26:2689-90.
Margolis D, Malay D, Hoffstad O, et al. Incidence of diabetic foot ulcer and lower extremity amputation among Medicare beneficiaries, 2006 to 2008. Data Points 2. Rockville, MD: Agency for Healthcare Research and Quality; 2011. AHRQ Publication No. 10(1)-EHC009-1-EF.
Wu S, Marston W, Armstrong D. Wound care: the role of advanced healing technologies. J Am Podiatr Med Assoc. 2010;100(5):385-94.
Redekop W, McDonnell J, Verboom P, Lovas K, Kalo Z. The cost effectiveness of Apligraf treatment of diabetic foot ulcers. Pharmacoeconomics. 2003;21(16):1171-83.
Vivas A, Choudhary S, Escandon J, Tang J, Lebrun E, Kirsner R. New therapies in treatment of diabetic foot ulcers: a review of clinical trials. Surg Technol Int. 2010;20:83-96.
Khaodhiar L, Dinh T, Schomacker K, et al. The use of medical hyperspectral technology to evaluate microcirculatory changes in diabetic foot ulcers and to predict clinical outcome. Diabetes Care. 2007;30: 903-10.
Boulton A. The importance of abnormal foot pressure and gait in causation of foot ulcers. En: Connor H, Boulton A, Ward JD, eds. The Foot in Diabetes. 1.a ed. Chichester: John Wiley and Sons; 1987. p. 11-26.
Veves A, Murray H, Young M, Boulton A. The risk of foot ulceration in diabetic patients with high foot pressure: a prospective study. Diabetologia. 1992;35:660-3.
Pham H, Armstrong D, Harvey C, Harkless L, Giurini J, Veves A. Screening techniques to identify people at high risk for diabetic foot ulceration. Diabetes Care. 2000;23:606-11.
Frykberg R, Lavery L, Pham H, Harvey C, Harkless L, Veves A. Role of neuropathy and high foot pressures in diabetic foot ulceration. Diabetes Care. 1998;21:1714-9.
Shah S. Clinical and Economic Benefits of Healing Diabetic Foot Ulcers With a Rigid Total Contact Cast. Wounds. 2012;24(6):152-9.
Boulton A. Pressure and the diabetic foot: clinical science and offloading techniques. Am J Surg. 2004;187:17S-24S.
Hissink R, Manning H, VanBall J. The MABAL shoe, an alternative method in contact casting for the treatment of neuropathic diabetic foot ulcers. Foot Ankle Int. 2000;21(4):320-3.
Nabuurs-Franssen M, Sleegers R, Hinjbert M, et al. Total contact casting of the diabetic foot in daily practice: a prospective follow up study. Diabetes Care. 2005;28:243-7.
Armstrong DG, Lavery LA, Wu S, Boulton A. Evaluation of removable and removable cast walkers in the healing of diabetic foot wounds. Diabetes Care. 2005;28:551-4. Gaceta Médica de México. 2014;150 64
Armstrong DG, Lavery LA, Kimbriel HR, Nixon BP, Boulton A. Activity patterns of patients with diabetic foot ulceration. Diabetes Care. 2003;26:2595-7.
Rathur HM, Boulton A. Pathogenesis of foot ulcers and the need for offloading. Horm Metab Res. 2005;37(1):61-8.
Piaggesi A, Macchiarini S, Rizzo L, et al. An off-the-shelf instant contact casting device for the management of diabetic foot ulcers: a randomized prospective trial versus traditional fiber glass cast. Diabetes Care. 2007;30:586-90.
Tamir E, Heim M, Siev-Ner I. Total contact cast for management of neuropathic ulceration of the foot. Harefuah. 2006;145(2):152-5, 163.
Bus SA, Valk GD, Van Deursen RW, et al. The effectiveness of footwear and offloading interventions to prevent and heal foot ulcers and reduce plantar pressure in diabetes: a systematic review. Diabetes Metab Res Rev. 2008;24:162-80.
Brand PW. The insensitive foot. Disorders of the foot and ankle. Medical and Surgical Management. 2.a ed. Filadelfia: WB Saunders; 1991. p. 2170.
Sinacore DR, Mueller MJ, Diamond JE, Blair III VP, Drury D, Rose SJ. Diabetic plantar ulcers treated by total contact casting: a clinical report. Phys Ther. 1987;67:1543-9.
Burnett O. Total contact cast. Clin Podiatr Med Surg. 1987;4:471-9.
Armstrong DG, Short B, Espensen EH, Abu-Rumman PL, Nixon BP, Boulton A. Technique for fabrication of an «instant total contact cast» for treatment of neuropathic diabetic foot ulcers. J Am Podiatr Med Assoc. 2002;92(7):405-8.
Wertsch JJ, Frank LW, Zhu H, Price MB, Harris GF, Alba HM. Plantar pressures with total contact casting. J Rehabil Res Dev. 1995;32(3):205-9.
Guzman B, Fisher G, Palladino SJ, Stavosky JW. Pressure-removing strategies in neuropathic ulcer therapy. An alternative to total contact casting. Clin Podiatr Med Surg. 1994;11(2):339-53.
Laing P. Diabetic foot ulce Am J Surg. 1994 Jan;167(1A):31S-36S.
Armstrong DG, Stacpoole-Shea S. Total contact cast and removable cast walkers. Mitigation of plantar heel pressure. J Am Podiatr Med Assoc. 1999;89:50-3.
Leibner ED, Brodsky JW, Pollo FE, Baum BS, Edmonds BW. Unloading mechanism in the total contact cast. Foot Ankle Int. 2006;27(4):281-5.
Shaw JE, Hsi WL, Ulbrecht JS, Norkitis A, Becker MB, Cavanagh PR. The mechanism of plantar unloading in total contact casts: implications for design and clinical use. Foot Ankle Int. 1997;18(12):809-17.
Walker SC, Helm PA, Pullium G; Total contact casting and chronic diabetic neuropathic foot ulcerations: healing rates by wound location. Arch Phys Med Rehabil. 1987;68(4):217-21.
Piaggesi A. An Off-the-shelf instant contact casting device for the management of diabetic foot ulcers. Diabetes Care. 2007;30(3):586-90.
Mueller MJ. Total contact casting in treatment of diabetic plantar ulcers: controlled clinical trial. Diabetes Care. 1989;12(6):384-8.
Armstrong DG, Nguyen HC, Lavery LA. Off-loading the diabetic foot wound: A randomized clinical trial. Diabetes Care. 2001;24(6):1019-22.
Coleman W, Brand PW, Birke JA. The total contact cast. A therapy for plantar ulceration on insensitive feet. J Am Podiatry Assoc. 1984;74(11):548-52.
Helm PA, Walker SC, Pulliam G. Total contact casting in diabetic patient with neuropatic foot ulcerations. Arch Phys Med Rehabil. 1984;65:692-3.
Sinacore DR. Total contact casting in the treatment of diabetic neuropatic ulcers. En: O’Neal LW, ed. 4.a ed. St. Louis: Mosby; 1988. p. 273-92.
Sinacore DR. Total contact casting for diabetic neuropathic ulcers. Phys Ther. 1996;76(3):296-301.
McGill M, Collins P, Bolton T, Yue DK. Management of neuorpathic ulceration. J Wound Care. 1996;5:52-4.
Bike JA, Patout CA. The total contact cast: an update and case study report. Wounds. 2000;12:26-31.
Huband MS, Carr JB. A simplified method of total contact for diabetic foot ulcers. Contemp Orthop. 1993;26(2):143-7.
Walker SC, Helm PA, Pollium G. Total-contact casting, sandals, and insoles. Construction and applications in a total foot-care program. Clin Podiatr Med Surg. 1995;12(1):63-73.
Baker RE. Total contact casting. J Am Podiatr Med Assoc. 1995;85(3): 172-6.
Sinacore DA. Total contact casting for diabetic neuropathic ulcers. Phys Ther. 1996;76(3):296-301.
Ali R, Qureshi A, Yaqoob MY, Shakil M. Total contact cast for neuropathic diabetic foot ulcers. J Coll Physicians Surg Pak. 2008; 18(11):695-8.
Bike JA, Sims DS, Buford WL. Walking casts: effect on plantar foot pressures. J Rehab Dev. 1985;22(3):18-22.
Muller MJ, Diamond JE, Sinacore DR, et al. Total contact casting in treatment of diabetic plantar ulcers. Controlled clinical trial. Diabetes Care. 1989;12(6):384-8.
Katz I, Harlan A, Miranda-Palma B, et al. A randomized trial of two irremovable offloading devices in the management of plantar neuropathic diabetic foot ulcers. Diabetes Care. 2005;28:555-9.
Myerson M, Papa J, Eaton K, Wilson K. The total-contact cast for management of neuropathic plantar ulceration of the foot. J Bone Joint Surg Am. 1992;74(2):261-9.
Wu SC, Crews RT, Armstrong DG. The pivotal role of offloading in the management of neuropathic foot ulceration. Curr Diab Rep. 2005; 5:423-9.
Armstrong DG, Lavery LA, Bushman TR. Peak foot pressures influence the healing time of diabetic foot ulcers treated with TCC. J Rehabil Res Dev. 1998;35:1-5.
Wu Sc, Jensen JL, Weber AK, Robinson DE, Armstrong DG. Use of pressure offloading devices in diabetic foot ulcers: do we practice what we preach? Diabetes Care. 2008;31:2118-9.
Carter MJ, Fife CE, Thomson B, Walker D. Estimating the applicability of wound care randomized controlled trials to general wound care populations by estimating the percentage of individuals excluded from a typical wound-care population in such trials. Adv Skin Wound Care. 2009;22:316-24.
Caravaggio, Faglia E, DeGiglio R, Mantero M, Quarantiello A, Sommariva E. Effectiveness and safety of a non-removable fiberglass offbearing cast versus a therapeutic shoe in the treatment of neuropathic foot ulcers: a randomized study. Diabetes Care. 2000;23:1746-51.
Fife CE, Carter MJ, Walker D. Why is it so hard to do the right thing in wound care? Wound Repair Regen. 2010:18;154-8.
Shah Sh. Clinical and Economic Benefits of Healing Diabetic Foot Ulcers With a Rigid Total Contact Cast. Wounds. 2012;24(6):152-9.
Fleischli JG, Lavery LA, Vela S, Ashry H, Lavery DC. Comparison strategies for reducing pressure at the site of neuropathic ulcers. J Am Podiat Med Assoc. 1997;87(10):466-72.
Birke JA, Pavich MA, Patout Jr CA, Horswell R. Comparison of forefoot ulcer healing using alternative off-loading methods in patients with diabetes mellitus. Adv Skin Wound Care. 2002;15(5):210-5.
Lavery LA, Armstrong DG, Walker SC. Healing rates of diabetic foot ulcers associated with midfoot fracture due to Charcot’s arthropathy. Diabet Med. 1997;14(1):46-9.