RT Journal Article
SR Electronic
T1 Nonremovable, Windowed, Fiberglass Cast Boot in the Treatment of Diabetic Plantar Ulcers
JF Diabetes Care
JO Diabetes Care
FD American Diabetes Association
SP 2848
OP 2852
DO 10.2337/diacare.26.10.2848
VO 26
IS 10
A1 Ha Van, Georges
A1 Siney, Hubert
A1 Hartmann-Heurtier, Agnes
A1 Jacqueminet, Sophie
A1 Greau, Françoise
A1 Grimaldi, André
YR 2003
UL http://care.diabetesjournals.org/content/26/10/2848.abstract
AB OBJECTIVE—To compare the efficacy, safety, and compliance of a nonremovable fiberglass cast boot and off-loading shoes in the treatment of diabetic plantar ulcers.RESEARCH DESIGN AND METHODS—Patients (n = 93) with noninfected, nonischemic plantar ulcers were included in this prospective nonrandomized study. Treatment used a nonremovable fiberglass cast boot for longer standing and deeper ulcers (n = 42) and a half shoe or heel-relief shoe for other ulcers (n = 51). We evaluated off-loading therapy, compliance, and complications in both groups.RESULTS—The healing rate was significantly higher with the cast boot than with the off-loading shoe (81 vs. 70%, P = 0.017), with healing times of 68.6 ± 35.1 vs. 134.2 ± 133.0 days, respectively, and hazard ratio 1.68 (95% CI 1.04–2.70); complete compliance with treatment was 98 vs. 10% (P = 0.001), respectively. Secondary osteomyelitis developed in 3 patients in the cast boot group and 13 patients in the off-loading shoe group (P = 0.026).CONCLUSIONS—A nonremovable fiberglass cast boot was effective in healing diabetic plantar ulcers and in decreasing the risk of secondary osteomyelitis. The cast boot forced compliance with off-loading, thus promoting healing.