Armstrong D G, Lavery L A, Bushman T R
Department of Orthopaedics, University of Texas Health Science Center, San Antonio 78284, USA.
J Rehabil Res Dev. 1998 Jan;35(1):1-5.
The purpose of this article is to describe the progression of ulcer healing using total contact casts (TCC) and to examine explanatory variables that may influence ulcer healing. We prospectively studied 25 diabetics with grade I (Meggitt-Wagner) plantar ulcers. All subjects received weekly contact cast changes with wound assessment. Following healing, all subjects were fitted with prescription shoe gear. Mean duration of casting until healing was 38.8 +/- 21.3 days. Individuals with pressures over 99 N/cm2 took longer to heal (33.1 +/- 13.0 vs. 53.4 +/- 31.4 days, P = 0.05) and had longer ulcer duration prior to treatment (52.7 +/- 37.2 vs. 180.7 +/- 145.0 days, P = 0.02). Subjects with wound size greater than 8 cm2 took longer to heal (50.2 +/- 26.2 vs. 29.9 +/- 10.6 days, P = 0.02). We conclude that subjects with high plantar pressures and wounds greater than 8 cm2 took significantly longer to heal when uniformly treated with TCC.
本文旨在描述使用全接触石膏（TCC）促进溃疡愈合的过程，并研究可能影响溃疡愈合的解释变量。我们前瞻性地研究了25例患有I级（梅吉特 - 瓦格纳分级）足底溃疡的糖尿病患者。所有受试者每周更换一次接触石膏并进行伤口评估。溃疡愈合后，所有受试者均配备定制鞋具。直至愈合的平均石膏固定时间为38.8±21.3天。足底压力超过99 N/cm2的个体愈合时间更长（33.1±13.0天对53.4±31.4天，P = 0.05），且治疗前溃疡持续时间更长（52.7±37.2天对180.7±145.0天，P = 0.02）。伤口面积大于8 cm2的受试者愈合时间更长（50.2±26.2天对29.9±10.6天，P = 0.02）。我们得出结论，当使用TCC进行统一治疗时，足底压力高且伤口面积大于8 cm2的受试者愈合时间明显更长。
