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Revolutionary Comfort Casting – A lightweight, bedside solution for diabetic foot disease

Pennine Acute Hospitals NHS Trust

Monica Berry, Research Podiatrist (Pennine Acute Hospitals NHS Trust), Professor Philip Wiles, Consultant Physician/Honorary Professor (Pennine Acute Hospitals NHS Trust/University of Salford), Louise Stuart, Consultant Podiatrist (Manchester PCT).

 

Monica Berry, Research Podiatrist (Pennine Acute Hospitals NHS Trust), Professor Philip Wiles, Consultant Physician/Honorary Professor (Pennine Acute Hospitals NHS Trust/University of Salford)People with diabetes-related foot disease have an increased mortality rate, a poor quality of life, chronic debility (for weeks, or even years), intolerable pain, life threatening infection and potential loss of limb. Existing casting devices used to treat diabetes related foot disease (air cast boots, plaster casts and Scotch casts, etc.) have inherent disadvantages. For example, they are associated with discomfort, time consuming application, expensive cutting equipment and difficulties arising from plaster room staff who may not be sensitive to the needs of these patients.

 

The Pennine Acute Hospitals NHS Trust diabetic foot team has developed the use of three novel soft cast devices to help solve the complex problems that present in diabetic feet:

  • Soft cast slippers to treat neuro-ischaemic foot
    ulceration (ulcers in numb feet with poor circulation)
  • Full below-knee casts for Charcot neuro-arthropathy
    (disruption of the bony foot architecture) and
    talonavicular fracture
  • Heel casts to off-load pressure from decubitus
    heel ulcers

These devices provide cheaper, lightweight (more comfortable) and cost effective alternatives to the traditional casts used to treat diabetic related foot disease. Following training, the new devices are easy to apply in any environment (clinic, ward, primary care or community settings). Importantly, using the soft cast slippers, casting can be used to treat ischaemic foot conditions and a trial is currently underway to evaluate this treatment method.

 

Image: Monica Berry, Research Podiatrist (Pennine Acute Hospitals NHS Trust), Professor Philip Wiles, Consultant Physician/Honorary Professor (Pennine Acute Hospitals NHS Trust/University of Salford).