Soft Cast for the diabetic foot?

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Dear all.
Last week i have been to Malvern Diabetic Foot Conference which takes place every other year in the U.K. Prof Andrew Boulton was chairman. A lot of new information was provided and many podiatrists from all over the world (From Brazil to Cameroon and Greece-Me could share their experiences and discuss about the diffficulties they meet in every country..(we in Greece meet a lot of them).
Anyway, my attention was gained by what they call "A soft cast", which is a new method of casting in order to offload diabetic foot ulcers. It is fairly easy to apply (much easier than the plaster cast)-about 30 mins procedure and patients tend to find it more comfortable and most of the times prefer it(from what i was told). I was provided with a dvd that includes the demonstration.We think we may start it in Grrece. Just wanted to ask if anybody else has heared about it and if so, what do they think and what is their experience. Thank you

 

Are you talking about the "Scotch cast" or 'Ambulatory' boot?

If you are, then the published evidence is that mean healing times in these is about twice as long as what it is for a total contact cast.

 

Neither of those

 

Are you able to post a picture?

 

We use a soft cast (also called scotch cast as that is the brand of cast that we use) in patients that can not tolerate fibreglass or plaster casts. We find the healing rates are longer than in a TCC but they do still promote healing and are more tolerable for the more sensitive patient. So it is a compromise but is better than nothing.

 

Wasn't there an article posted on this site a week or so ago that showed healing times could be comparable to a TCC if applied so that they couldn't be taken off (i.e wrapped in a self adhesive bandage), suggesting that the offloading capacity is similar but the effects are hindered by poor patient compliance?

 

Yes, the first one.

 

I AM VERY SORRY BUT STILL NO PICTURE IS AVAILABLE.VERY SOON THOUGH. THE CONCEPT IS THAT NO FIBRE GLASS IS USED AS STATED IN THE FOLLOWING REPLY

 

SOFT CAST is not the same as SCOTCH CAST PLUS,

They are both made by 3M and you should visit their website for more information.

Basically soft cast is a glass filament casting material (exactly the same as scotch cast) BUT the resin is formualted differently, and the material does not set to a fully rigid material UNLIKE scotchcast. It is primarily used to provide FUNCTIONALtreatment of fractures.

The major advantage is that you do not need a cast saw to remove the SOFT CAST as it can be cut with scissors.

The concept is that soft cast can be used to reproduce the gold standard of TOTAL CONTACT as you do not need cast padding underneath, in a lightweight boot rather than a below knee cast. The sole plate of the boot is strengthen with SCOTCHCAST PLUS the rigid material.

This concept works extremely well and has been used in the UK for a while now to offload pressure in treating diabetic foot ulcers. It is also used to maintain stability in early charcot foot. Patients prefer this as it is lightweight and more comfortable than a removable Scotchcast boot or a TCC.

I would STRONGLY recommend that you contact your local 3M healthcare rep for more information they have a book and DVD woth full instructions.


Another advantage is that is works out to be very cost effective!! Good news for the NHS!.

I hope that this helps explain the porcess a little Im happy for you to contact me through here for further info if you like.

Rob Bradbury

 

Hi,

I would like to know more about the soft cast with enhanced scotchcast sole.
I have attended a couple of months in a podiatry clinic but I appreciate if u have more practical aspects to follow or a video tutorial or so..

Thanx

 

Problems with fibre glass close contact casting.

Patient aversion to oscillating saw.
Heat from blunt blade and risk of lesions over bony when valving/removing.
Weakness of cast after valving, comprised functional immobilisation/shear reduction.
Fitting cast securely within walker frame.
Any concurrence or debate with these difficulties or others?


My background is podiatry (4 yrs training/study) and engineering (1 year to receive B.Sc (Hons) human science), .
Following SMART award focusing on novel cast for lower limb, have patents for design and materials combination and recipe, working prototype and potential manufacturing company.
All feedback gratefully received . Thank-you..

 

As mentioned already soft cast is a different material to scotch cast. We have known of soft cast in our clinic since Louise Stuart and co first mentioned it in 2010 as part of the fduk conference. At present we use scotch cast for our tcc, soft cast for our soft cast heel cup (with good results for low grade pressure/heel ulcers) and a mix of soft cast and prima cast for our slipper casts. Both the heel cup and slipper cast are easy enough to make in a patients home once you've made a few. But as with all ulcers it's not a miracle cure and what will work with one won't always with another!

 

Has anyone got a video demo of this being applied. I would be really interested to see it?