Ganguly Suparno, Chakraborty Koustubh, Mandal Pankaj Kumar, Ballav Ambar, Choudhury Subhankar, Bagchi Subrata, Mukherjee Satinath
Department of Physical Medicine and Rehabilitation, Institute of Postgraduate Medical Education and Research, Kolkata 700020.
J Indian Med Assoc. 2008 Apr;106(4):237-9, 244.
Of all non-traumatic amputations 50% occur in Diabetics, mostly as a final outcome of foot ulcers. A major biomechanical factor in the causation of foot ulcers in persons with diabetes mellitus is elevated peak plantar pressure. Offloading the ulcer area in the form of equalisation of pressure across the plantar surface can accelerate healing of the ulcer. Total contact casting is one such method of offloading, and this study attempts to investigate the advantages of the above method as compared to conventional dressings in the physiatric management of the depth--ischaemia grades 1A, 1B, 2A, 2B neuropathic plantar ulcers in a diabetic patient. The outcome measure was the time taken for complete resolution of the ulcers. Of the 29 patients in Category A treated with total contact casting involving a total of 39 foot ulcers, 36 healed, which was statistically significant (p < 0.05) as compared to 25 out of the 33 ulcers healing in Category B consisting of 26 patients treated by conventional dressings alone. Total contact casting is an effective, rapid, economical, ambulatory and outpatient--based method for the treatment of diabetic foot ulcers.
在所有非创伤性截肢病例中，50%发生在糖尿病患者身上，大多是足部溃疡的最终结果。糖尿病患者足部溃疡形成的一个主要生物力学因素是足底峰值压力升高。通过使足底表面压力均衡的方式减轻溃疡部位的压力，可以加速溃疡愈合。全接触石膏固定就是这样一种减压方法，本研究试图探讨上述方法与传统敷料相比，在糖尿病患者1A、1B、2A、2B级深度缺血性神经性足底溃疡物理治疗中的优势。结果指标是溃疡完全愈合所需的时间。A组29例患者采用全接触石膏固定治疗，共涉及39处足部溃疡，其中36处愈合，与仅采用传统敷料治疗的B组26例患者的33处溃疡中25处愈合相比，具有统计学意义（p<0.05）。全接触石膏固定是一种有效、快速、经济、可在门诊进行的糖尿病足溃疡治疗方法。
