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Removable and irremovable cast walkers

Discussion in 'Diabetic Foot & Wound Management' started by admin, Feb 26, 2005.

  1. admin

    admin Administrator Staff Member


    Members do not see these Ads. Sign Up.
    The latest Diabetes Care has two papers on this:

    Evaluation of Removable and Irremovable Cast Walkers in the Healing of Diabetic Foot Wounds A randomized controlled trial
    David G. Armstrong, Lawrence A. Lavery, Stephanie Wu, Andrew J.M. Boulton

    A Randomized Trial of Two Irremovable Off-Loading Devices in the Management of Plantar Neuropathic Diabetic Foot Ulcers
    Ira A. Katz, Anthony Harlan, Bresta Miranda-Palma, Luz Prieto-Sanchez, David G. Armstrong, John H. Bowker, Mark S. Mizel, Andrew J.M. Boulton
     
  2. admin

    admin Administrator Staff Member

    Thanks David for the picture:

    [​IMG]
     
    Last edited: Mar 24, 2005
  3. dbelyea

    dbelyea Member

    cohesive bandage??

    Hi,
    I was wondering if anyone could let me know what material the 'cohesive bandage' was that was used in this study. Would a layer of fiberglass work as this cohesive bandage.
    I am very interested to know as we have several pt's we would like to try this technique on.
    Thanks.
     
  4. johnmccall

    johnmccall Active Member

    Looks as if Scotchcast or fibreglass bandage would do fine.

    I haven't tried this yet and I like the idea. What about simply wrapping a couple of layers of bandage around the straps, rather than bulking out the whole Air Cast? Would fibreglass bandage adhere too much to the air cast?Regards to all from Sunny Ayrshire, Scotland.
    John
     
  5. Tuckersm

    Tuckersm Well-Known Member

    cohesive Bandage

    A Cohesive bandage is a specialty bandage which sticks only to itself, and can be peeled of with no special equipment. Commonly used as the outer layer of leg ulcer dressings eg S&N Profore* Four Layer Compression Bandage System For Leg Ulcer Management.

    It is available from many medical suppliers and for a picture see below. Comes in many different colour, including skin tone
     

    Attached Files:

  6. Armstrong

    Armstrong Member

    Instant TCC (iTCC)

    One may, frankly, use whatever one wants to when converting a removable cast walker (RCW) to an irremovable one.

    After preparing the foot (in a similar fashion to a TCC-- see www.diabetic-foot.net for details) We tend to initially use coban (cohesive bandage), wrapped over the entire RCW (usually either a DH Walker or Aircast Diabetic Walker). We then have the patient back in two days to evaluate for any irritation. If there is any irritation, we may pad the area with cotton padding (webril/cast padding). We then have the patient back weekly.

    Cheers,

    DGA

    David. G. Armstrong
    Professor of Surgery
    Chair of Research and Assistant Dean
    Dr. William M. Scholl College of Podiatric Medicine at
    Rosalind Franklin University of Medicine

    Director,
    Center for Lower Extremity Ambulatory Research (CLEAR) at
    Rosalind Franklin University of Medicine and Science
    http://www.rosalindfranklin.edu/scpm/clear
    http://www.diabetic-foot.net
     
  7. dbelyea

    dbelyea Member

    Lockable removable cast walkers

    I was wondering if anyone knew if there has been any thought or development into removable cast walkers with a locking mechanism attached, so pts were unable to remove the walker themselves?? It would be doing much the same as the cohesive bandage with less time and resourses needed.
    Its an idea which im sure other people have already thought of.
     
  8. Craig Payne

    Craig Payne Moderator

    Articles:
    6
    It would make sense to do that.

    At the end of the day:
    1. Biomechanical/lab studies have shown the removable cast walkers to be just as effective as TCC in reducing plantar pressures

    2. Research has shown the TCC to be more effective clinically than the reemovable walker (eg here)

    3. Compliance with the use of the removable walker has been show to be very bad (which could account for the paradox between (1) and (2) above)

    4. If the removable walker can be made nonremovable (by whatever means), then (3) is addressed and (2) may change - and its cheaper and quicker to apply.
     
    Last edited by a moderator: Mar 10, 2005
  9. NewsBot

    NewsBot The Admin that posts the news.

    Articles:
    1
    Here is video clip of the iTCC:

     
    Last edited by a moderator: Sep 22, 2016
  10. NewsBot

    NewsBot The Admin that posts the news.

    Articles:
    1
    Effectiveness of removable walker cast versus non-removable fiberglass off-bearing cast in the healing of diabetic plantar foot ulcer- a randomized controlled trial.
    Ezio F, Carlo C, Giacomo C, Adriana S, Vincenzo C, Vanda V, Daniele S, Francesco S.
    Diabetes Care. 2010 Mar 31. [Epub ahead of print]
     
  11. NewsBot

    NewsBot The Admin that posts the news.

    Articles:
    1
    Effectiveness of Removable Walker Cast Versus Nonremovable Fiberglass Off-Bearing Cast in the Healing of Diabetic Plantar Foot Ulcer A randomized controlled trial
    Ezio Faglia et al
    Diabetes Care July 2010 vol. 33 no. 7 1419-1423
     
  12. daviebaby999

    daviebaby999 Welcome New Poster

    hi my name is david and i work in dublin ireland in an orthopaedic plaster room. i do alot of TCC casts both removable and none. to be honest i think some people are missing the point of tcc cast in that you have to make sure the underneath of the cast is a rocker sole. remember its not what u put on the uncer is all about the offload. i have messed around with many a design and i have come up with a new type of cast, its called the rocker clog. its is what it says it is ( looks like a clog and it has a rocker sole.) it has showed healing within 2 weeks and most cast only are on patients while they walk about and are taken off when resting. also the use with manuka honey has showed healing to help with the healing times, but dont know weather its the cast or both. the cast is made with delta cast conforable (DCC) SMITH AND NEPHEW as its got a 3way woven fibre and its next to impossible to get any creases or ridges. i work closely with the diabetic team here in the hospital but sadly my ortho[paedic dept does not see many patients with foot ulcers so i am going to the uk and ply my skill.

    i think more orthopeadice technicians like me need to come on forums like this to learn from people like u and vice versa.
    many thanks .


    dmccarthy@stjames.ie colles999@msn.com
     
  13. NewsBot

    NewsBot The Admin that posts the news.

    Articles:
    1
    Removable cast walker boots yield greater forefoot off-loading than total contact casts.
    Gutekunst DJ, Hastings MK, Bohnert KL, Strube MJ, Sinacore DR.
    Clin Biomech (Bristol, Avon). 2011 Apr 13. [Epub ahead of print]
     
  14. NewsBot

    NewsBot The Admin that posts the news.

    Articles:
    1
    Removable Walker Is as Safe and Effective as Total Contact Cast (TCC) and Irremovable Walker in Healing Neuropathic Diabetic Foot Ulceration (DFU)
    ALBERTO PIAGGESI, SILVIA MACCHIARINI, CHIARA MATTALIANO, GIACOMO CLERICI, FABIO ROMAGNOLI, CRISTIANA VERMIGLI, FABRIZIA TOSCANELLA, ELISABETTA IACOPI
    Presented at the 74th American Diabetes Association Mtg; San Francisco; June 14-17 2014
     
  15. NewsBot

    NewsBot The Admin that posts the news.

    Articles:
    1
  16. NewsBot

    NewsBot The Admin that posts the news.

    Articles:
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    Biomechanical Assessment of TCC-EZ® Kits for Diabetic Foot Ulcers
    Aakshita Monga et al
    Source
     
  17. NewsBot

    NewsBot The Admin that posts the news.

    Articles:
    1
    Commitment devices in the treatment of diabetic foot ulcers
    Gustav Jarl
    Journal of Foot and Ankle Researchvolume 12, Article number: 44 (2019)
     
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