| Q: What is the criteria for Total Contact Casting? Has anyone got a policy or set of guidelines that they currently use? ... Has anyone got a patient advice leaflet for contact casting for DFU? ... am now fortunate to be working in a Trust where Total Contact Casting is available for patients with diabetic foot ulceration. - post Q: I am now fortunate to be working in a Trust where Total Contact Casting is available for patients with diabetic foot ulceration. Whilst I'm aware that this is often quoted as "Gold Standard" it appears that on a practical basis patient selection and mode of application varies even amongst neighbouring areas. Our Diabetic Foot Team is keen to explore how we can ensure we are selecting the right pts for casting, identifying the known risks in order that we can ensure the patient is giving informed consent to casting etc. With that in mind is anyone able to point me in the direction of some definitive answers eg: Total Contact Casting is contra-indicated if patient has ischaemia – but what measure should be used for this – clinical presentation? monophasic pulses? ABPI's – if so at what value? Has anyone got a policy or set of guidelines that they currently use? Has anyone got a patient advice leaflet for contact casting for DFU? On a practical note quite a number of pts seem to clunk their other foot with the cast – does anyone issue any cover/silicone sock etc as a prevention? Any other helpful comments would be gratefully received. R: I am working with a MDF Team that does do Total Contact Casting where indicated either for active Charcot foot or chronic neuropathic ulceration ... if we cast a client we will go through with them what is involved in TCC and have a pre evaluation ... Post Total Contact Casting the client is usally in either a diabetic walker or a CROW initally ... full post |
Q:Recently i have started applying total contact cast for plantar ulcers.initial results were satisfactory. but after 3 months they came with the recurrent ulcers. please guide me how to prevent this? about foot wear modifications. - post |
