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 from the Rosalind Franklin University of Medicine and Science, North Chicago, USA said that wounds don't heal very well with removable devices because of he fact that they are removable. They 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. They postulated that the reason these removable devices weren't working was because they weren't being worn. So this 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
Diabetes Care,
March 2005
March 2005