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Healing a diabetic ulcer with total contact casting

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Traditional total contact casting has long been considered to be the “Gold Standard” for the offloading of diabetic and neuropathic plantar foot ulcerations.  Total contact casting is a simple way to reduce pressure on the bottom of the foot without comprising the activity of a patient or causing additional ulcerations from a regular type of cast.

Some patients can’t stay off of their feet to reduce pressures and total contact casting remains the best first line modality for the management of diabetic foot ulcerations on patient non-infected wounds of over 2-3 months duration.

The clinical evidence of total contact casting:

  • 88% of diabetic foot ulcerations heal within six weeks when total contact casting is utilized to offload.
  • Casting is over 30% more effective than higher cost alternative modalities.
  • 15% of patients with diabetes are at risk of developing a diabetic foot ulceration.
  • 85% of lower extremity amputations in diabetic patients were preceded by an foot ulceration.
  • There is a 50% 3 year morbidity rate in post lower limb amputations among diabetic patients.
  • The cost of treating a patient utilizing total contact casting is nearly 50% of alternative modalities.

This clinical evidence is taken from Kinectic Casting Solutions.

Total Contact Casting Utilized In Conjunction With Tissue

Substitutes May Reduce Time To Closure. Primatrix skin graft In this photo we are using primatrix biologic skin graft made from fetal bovine material. Our St. Louis based podiatry office uses the Maxcast Plus traditional total contact casting system.

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Dr. Dennis Timko, is a podiatrist in the St. Louis, Eureka, MO. area. Dr. Timko specializes in diabetic foot care, foot surgery, AFOs, and orthotics. Dr. Timko is the solo owner of Arch City Foot & Ankle, which has been in business since 2003.

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