Total Contact Casting

By the WoundSource Editors

Advanced wound care technologies have come a long way in treating chronic wounds. However, diabetic foot ulcers (DFUs) can be challenging, and not every patient should have identical treatment. Utilizing a patient-centered approach is necessary for selecting appropriate treatments and achieving best possible outcomes. Understanding the specific patient’s needs and understanding the pathophysiology of diabetic wound chronicity are key elements in DFU management. The primary goal should be wound closure, while also preventing recurrence. To achieve both goals, clinicians must incorporate ongoing education and clinical support. Health care professionals should keep up on latest evidence-based research and practices to select the best advanced treatment for each patient.

By Miranda J. Henry, Editorial Director of WoundSource

This updated edition of WoundSource provides a glimpse of the continuing evolution of the field of wound care. There are several additions this year that reflect the innovation and ingenuity we are seeing in wound management.

By James McGuire, DPM, PT, LPed, FAPWH

Editor's note:This blog post is part of the WoundSource Trending Topics series, bringing you insight into the latest clinical issues and advancement in wound management, with contributions by the WoundSource Editorial Advisory Board.

By Martin D. Vera LVN, CWS

In this last of our three-part series on lower extremity wounds, we will focus our attention on diabetic foot/neuropathic ulcers. Research indicates that the United States national average for diabetes mellitus (DM) accounts for a little over 8% of the nation, or roughly over 18 million Americans afflicted with this disease—what the industry refers to "the silent killer" for the amount of damage it causes. DM has the capacity to affect vision and circulation, as well as increase the incidence of stroke and renal disease, just to name a few associated problems. Over 20% of individuals with diabetes will develop ulcerations, with a recurrence rate of over 50% for diabetic foot ulcers (DFUs) alone. Overall, lower extremity wounds have recurrence rate of 40-90%. We have our work cut out for us. So, let's put our deuces up, recognize early intervention, and try our best to manage and prevent complications associated with DM.

By Laurie Swezey RN, BSN, CWOCN, CWS, FACCWS

Total contact casting (TCC) is considered to be the 'gold standard' in the treatment of diabetic foot ulcers. Although TCC is often very successful in healing diabetic foot ulcers, this treatment modality is not used as often as it could be.

By Aletha Tippett MD

The great medical pioneer, Dr. Paul Brand, was right when he said it's not about medicine, it's about mechanics. Think of the ulcers you are asked to see and treat. I hope the first question you ask about any wound is "how did this get here?" If the mechanics of a wound are not addressed, the medicine will not be successful.

By Thomas E. Serena MD, FACS, FACHM, FAPWCA

I had the honor of lecturing to an audience of mostly European physicians at the M.I.L.A.N. Diabetic Foot Conference this past February in Milan, Italy. My session this year focused on our current and ongoing research in point-of-care diagnostics. To date, we have enrolled more than a thousand patients in a dozen clinics across the United States. All of these trials led to the development of the first commercially available wound diagnostic, WOUNDCHEK (Systagenix, Gargarve, UK), approved in Europe last year (it has not yet received FDA clearance for use in the US). A revolutionary product, I imagined that it would have received rapid, wide-spread acceptance among my European colleagues. At the end of the presentation I asked for a show of hands: “How many of you are using the test in your clinics or hospitals.” In an audience of nearly one hundred, only three attendees raised their hands.