Those who do Wound Care -
Do you see much use of the so-called "gold standard" for offloading weight and pressure from foot ulcers/wounds?
Our Wound Care Clinic uses it after making sure any infection is cleared up. They put a cast on, have the pt come back in 2 days to make sure the cast is not causing any new problems due to rough edges, being too tight, etc.
Then they put a new cast on and have the pt come back in a week.
The whole foot, toes and all, is enclosed, so neurovascular checks are impossible to do. I find this worrisome.
What about those in Wound Care who do not see total contact casts used? What do you use? Or, I should say, even if you do use the casts, do you also see these used? More to the point, what do you think of them? What would your plan be for healing diabetic foot ulcers? What care would you want yourself or your loved one to receive for a diabetic ulcer if you could choose any and all therapies, without regard to cost or availability?
ultrasonic debridement tools?
negative pressure therapy?
platelet derived growth factors?
bioengineered skin substitutes?
What types of dressings do you see? Aquacel with silver? absorbing foam? (I personally think this is the neatest thing!); Coban? (this is another thing that deserves the Nobel prize. It prevents pulling sensitive skin the way adhesives do).
Hey, thanks for your input everyone.
Sep 30, '13
There's a wound care forum in AN-- go to the "Specialties" area in the yellow bar up top and find them. They are very helpful.
Sep 30, '13
Moved to Wound/Ostomy/Continence Forum for best response.
Nov 13, '13
TCC is indeed a gold standard for offloading a foot wound. Everything else you mention (and there are many more) are advanced modalities and are finely-tuned and individualized for the patient's particular issue.