Comparison Between Ordinary Dressing And Total Cast Offloading Dressing In Diabetic Foot Ulcer Patients

Published by M-Med | Educational content for wound care professionals

This 2024 randomized controlled trial evaluated the effectiveness of total contact casting compared to ordinary dressings in the management of diabetic foot ulcers (DFUs). Conducted at Vinayaka Mission's Kirupananda Variyar Medical College and Hospital in Salem, Tamil Nadu, India, the study enrolled 160 patients with Wagner grade 1 or 2 DFUs. Participants were randomly assigned to receive either standard wound care with ordinary dressings or total contact casting.

Key Findings

The group treated with total contact casting demonstrated a significantly higher rate of complete ulcer healing (72.5%) compared to the ordinary dressing group (53.75%). Additionally, patients in the total contact casting group experienced faster healing times, with 27.5% achieving healing in less than 4 weeks versus 12.5% in the ordinary dressing group. The incidence of complications, such as infections and skin irritation, was also lower in the total contact casting group.

Patient Satisfaction and Mobility

Patients treated with total contact casting reported higher satisfaction levels and improved mobility. Specifically, 67.5% of patients in the total contact casting group reported high satisfaction, compared to 43.75% in the ordinary dressing group. Improved mobility was reported by 60% of patients in the total contact casting group versus 31.25% in the ordinary dressing group.

Conclusion

The study concludes that total contact casting is more effective than ordinary dressings in promoting the healing of diabetic foot ulcers. The findings suggest that total contact casting should be considered more routinely in the management of DFUs, given its association with higher healing rates, reduced complications, and increased patient satisfaction.