Comparison Between Ordinary Dressing And Total Cast Offloading Dressing In Diabetic Foot Ulcer Patients.

Abstract

Background: Diabetic foot ulcers (DFUs) are a common and serious complication of diabetes, leading to significant morbidity and increased mortality. Effective management of DFUs is critical to prevent complications, including amputations. Traditional dressings are widely used but may not adequately offload pressure from the ulcerated area, while total cast offloading is considered more effective in pressure alleviation but less frequently utilized due to perceived patient inconvenience and cost.

Objective: To compare the efficacy of ordinary dressing methods with total cast offloading in the healing of diabetic foot ulcers among a sample of 160 patients.

Methods: This randomized controlled trial enrolled 160 patients with grade 1 or 2 diabetic foot ulcers, as classified by the Wagner scale. Patients were randomly assigned to receive either standard wound care with ordinary dressings (n=80) or total cast offloading (n=80). The primary outcome was the rate of complete ulcer healing over a 12-week period. Secondary outcomes included healing time, infection rates, and patient-reported satisfaction.

Results: The total cast offloading group demonstrated a significantly higher rate of complete ulcer healing (72.5%) compared to the ordinary dressing group (53.75%) (p < 0.05). Additionally, the average healing time was shorter, and fewer infections were reported in the total cast offloading group. Patient satisfaction scores were also higher in the cast offloading group, despite initial reservations about comfort and mobility.

Conclusion: Total cast offloading is more effective than ordinary dressings in promoting the healing of diabetic foot ulcers, suggesting that it should be considered more routinely in the management of this condition. The benefits of improved healing rates and reduced complications may outweigh the concerns regarding patient mobility and cost.