| Autor: |
Katz, Ira A., Harlan, Anthony, Miranda-Palma, Bresta, Prieto-Sanchez, Luz, Armstrong, David G., Bowker, John H., Mizel, Mark S., Boulton, Andrew J. M. |
| Předmět: |
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| Zdroj: |
Diabetes Care; Mar2005, Vol. 28 Issue 3, p555-559, 4p, 1 Black and White Photograph, 3 Charts, 1 Graph |
| Abstrakt: |
OBJECTIVE -- The purpose of this study was to compare the effectiveness of a removable cast walker (RCW) rendered irremovable (iTCC) with the total contact cast (TCC) in the treatment of diabetic neuropathic plantar foot ulcers. RESEARCH DESIGN AND METHODS -- In a prospective, randomized, controlled trial, 41 consecutive diabetic patients with chronic, nonischemic, neuropathic plantar foot ulcers were randomly assigned to one of two groups: a RCW rendered irremovable by wrapping it with a single layer of fiberglass casting material (i.e., an iTCC) or a standard TCC. Primary outcome measures were the proportion of patients with ulcers that healed at ≤ 12 weeks, healing rates, complication rates, cast placement/removal times, and costs. RESULTS -- The proportions of patients with ulcers that healed within 12 weeks in the iTCC and TCC groups were 80 and 74%, respectively (94 and 93%, respectively, when patients who were lost to follow-up were excluded). Survival analysis (healing rates) was statistically equivalent in the two groups, as were complication rates, but with a trend toward benefit in the iTCC group. The iTCC took significantly less time to place and remove than the TCC with 39% and 36% reductions, respectively. There was also an overall lower cost associated with the use of the iTCC compared with the TCC. CONCLUSIONS -- The iTCC may be equally efficacious, faster to place, easier to use, and less expensive than the TCC in the treatment of diabetic plantar neuropathic foot ulcers. [ABSTRACT FROM AUTHOR] |
| Databáze: |
Complementary Index |
| Externí odkaz: |
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