This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Armstrong, D. G. Articles by Boulton, A. J. M. Search for Related Content PubMed PubMed Citation Articles by Armstrong, D. G. Articles by Boulton, A. J. M.

Technique for Fabrication of an "Instant Total-Contact Cast" for Treatment of Neuropathic Diabetic Foot Ulcers

David G. Armstrong, DPM^*, Brian Short, DPM, Eric H. Espensen, DPM, Patricia L. Abu-Rumman, DPM, Brent P. Nixon, DPM and Andrew J. M. Boulton, MD^||

^* Director of Research and Education, Department of Surgery, Podiatry Section, Southern Arizona Veterans Affairs Medical Center, Tucson; Visiting Senior Lecturer, Department of Medicine, Manchester Royal Infirmary, Manchester, England. Mailing address: Department of Surgery, Podiatry Section, Southern Arizona Veterans Affairs Medical Center, 3601 S Sixth Ave, Tucson, AZ 85723.
Submitted during second-year residency, Department of Surgery, Podiatry Section, Southern Arizona Veterans Affairs Medical Center, Tucson.
Attending Physician, Diabetic Foot Center, Providence St Joseph Medical Center, Burbank, CA.
Chief, Department of Surgery, Podiatry Section, Southern Arizona Veterans Affairs Medical Center, Tucson.
^|| Professor, Department of Medicine, Manchester Royal Infirmary, Manchester, England.

Abstract

Addressing pressure reduction in the treatment of diabetic foot wounds is a critical component of therapy. The total-contact cast has proven to be the gold standard of treatment because of its ability to reduce pressure and facilitate patient adherence to the off-loading regimen. Removable cast walkers have proven to be as effective as total-contact casts in pressure reduction, but this has not translated into equivalent time to healing. A simple technique to convert the removable cast walker into a device that is not as easily detached from the lower extremity, thereby encouraging the use of this device over a 24-hour period, is presented in this article. The procedure involves wrapping the cast walker with cohesive bandage or plaster of Paris. In the authors’ opinion, this technique addresses many of the disadvantages of the total-contact cast, resulting in an adequate compromise in this aspect of care. (J Am Podiatr Med Assoc 92(7): 405-408, 2002)

This article has been cited by other articles:

				D. G. Armstrong, M. A. Rosales, and A. Gashi Efficacy of Fifth Metatarsal Head Resection for Treatment of Chronic Diabetic Foot Ulceration J Am Podiatr Med Assoc, July 1, 2005; 95(4): 353 - 356. [Abstract] [Full Text] [PDF]

				D. G. Armstrong, L. A. Lavery, S. Wu, and A. J.M. Boulton Evaluation of Removable and Irremovable Cast Walkers in the Healing of Diabetic Foot Wounds: A randomized controlled trial Diabetes Care, March 1, 2005; 28(3): 551 - 554. [Abstract] [Full Text] [PDF]

				I. A. Katz, A. Harlan, B. Miranda-Palma, L. Prieto-Sanchez, D. G. Armstrong, J. H. Bowker, M. S. Mizel, and A. J.M. Boulton A Randomized Trial of Two Irremovable Off-Loading Devices in the Management of Plantar Neuropathic Diabetic Foot Ulcers Diabetes Care, March 1, 2005; 28(3): 555 - 559. [Abstract] [Full Text] [PDF]

				D. G. Armstrong and A. J. M. Boulton Pressure Offloading and "Advanced" Wound Healing: Isn't It Finally Time for an Arranged Marriage? International Journal of Lower Extremity Wounds, December 1, 2004; 3(4): 184 - 187. [PDF]

				D. G. Armstrong, K. Kunze, B. R. Martin, H. R. Kimbriel, B. P. Nixon, and A. J. M. Boulton Plantar Pressure Changes Using a Novel Negative Pressure Wound Therapy Technique J Am Podiatr Med Assoc, September 1, 2004; 94(5): 456 - 460. [Abstract] [Full Text] [PDF]

				A. J.M. Boulton, R. S. Kirsner, and L. Vileikyte Neuropathic Diabetic Foot Ulcers N. Engl. J. Med., July 1, 2004; 351(1): 48 - 55. [Full Text] [PDF]

				D. G. Armstrong and L. A. Lavery Decreasing Foot Pressures While Implementing Topical Negative Pressure (Vacuum-Assisted Closure) Therapy International Journal of Lower Extremity Wounds, March 1, 2004; 3(1): 12 - 15. [Abstract] [PDF]

				A. J.M. Boulton and D. G. Armstrong Off-Loading in Trials of Neuropathic Diabetic Foot Ulceration: Further evidence of the need for a paradigm shift Diabetes Care, February 1, 2004; 27(2): 636 - 637. [Full Text] [PDF]

				D. G. Armstrong, L. A. Lavery, J. R. Vazquez, B. Short, H. R. Kimbriel, B. P. Nixon, and A. J.M. Boulton Clinical Efficacy of the First Metatarsophalangeal Joint Arthroplasty as a Curative Procedure for Hallux Interphalangeal Joint Wounds in Patients with Diabetes Diabetes Care, December 1, 2003; 26(12): 3284 - 3287. [Abstract] [Full Text] [PDF]

				A. J. M. Boulton and D. G. Armstrong Trials in Neuropathic Diabetic Foot Ulceration: Time for a paradigm shift? Diabetes Care, September 1, 2003; 26(9): 2689 - 2690. [Full Text] [PDF]