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Monday, July 16, 2012

Plaster of Paris (POP) Cast for Diabetic Foot Ulcer Healing

Posted by Dr Prahallad Panda on 5:41 PM 2 comments

Diabetic foot ulcers, the tropic ulcers are very difficult to heal. It takes months and may not heal also. Diabetic foot ulcers occur and persists for variety of reasons. Mostly, these are due to;
  •  Uncontrolled blood glucose level, hampering the body defence mechanism to fight infection.
  • Poor blood supply due to changes in the blood vessels secondary to diabetes; helps to maintain the ulcer.
  • Blunted sensation from foot due to changes in peripheral nerves, making the injuries in foot go unnoticed.
  • Collapse of foot arch due to neuropathy and myopathy, giving rise new pressure points in the plantar aspect.
  • Friction from incorrect foot wear.
  • Lack of rest to foot.
    diabetic foot syndrome
    diabetic foot syndrome (Photo credit: Wikipedia
It has been seen that giving rest to foot helps in wound healing in leprotic foot ulcers. Usually, a Plaster of Paris (POP) Cast is applied after dressing and kept for one or two weeks, along with some antibiotics of ciprofloxacin group.
I tested this way in diabetic foot ulcers, after debridement, control of infection, control of blood glucose level and wound dressing; and got the success.
In literature, there is narration of Total Contact Cast (TCC) that helps in off loading the weight of the patient and is costly. In POP cast the cost is less and the foot also gets adequate rest. 
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