Efficacy of total contact cast application versus conventional dressings in the management of plantar diabetic ulcers

Abstract

Introduction: Neuropathic ulcers are the prime precipitant of diabetes-related amputations of the lower extremity. Traditionally, diabetic foot ulcers are treated with regular dressings with frequent debridements with minimal weight bearing on the affected foot. The key element of any treatment programme designed to heal these wounds is effective reduction in pressure (offloading). Materials and Methods: This study was carried out in the Department of General Surgery, JSS Academy of Higher Education and Research, Mysuru, India from January 2020 to December 2020. This is an observational study and the data was collected prospectively. All diabetic patients with foot ulcers, who were admitted as in-patients, who gave consent, meeting the inclusion criteria were enrolled in the study. Patient’s history, clinical, biochemical and radiological data were collected. Results: A total of 50 patients were included in the study. In that, the average age of patients in Group P was 55.6 years and in Group C was 57.8 years. Group P had 17 males and 8 females and Group C had 18 males and 7 females. Average duration of diabetes in Group P was 6.7 years and in Group C was 5.6 years. Mean HbA1c values of patients in Group C was 8.4% and in Group P was 8.3%; 73% of patients presented with ulcer secondary to trauma and in 27% of the patients the cause was unknown or had spontaneously occurred. Conclusion: Surgical debridement is the cornerstone of management of diabetic foot ulcers. Purified placental extract dressings showed faster and better healing rates when compared with conventional dressings.