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Plaster Casts in the Management of Advanced Ischaemic and Neuropathic Diabetic Foot Lesions
Author(s) -
Borssén B.,
Lithner F.
Publication year - 1989
Publication title -
diabetic medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.474
H-Index - 145
eISSN - 1464-5491
pISSN - 0742-3071
DOI - 10.1111/j.1464-5491.1989.tb01264.x
Subject(s) - medicine , amputation , ankle , surgery , diabetic foot , foot (prosody) , prospective cohort study , diabetes mellitus , ischemia , linguistics , philosophy , endocrinology
The outcome of plaster cast treatment of diabetic ulcerations at different sites of the feet in 33 patients was assessed in a prospective study. They were selected for the study because the previous conservative treatment had been unsuccessful. The mean age was 68 years and Type 1/Type 2 ratio was 4/29. Fifteen patients had lesions of grade 2 severity according to Wagner's classification, 9 patients' lesions were grade 3, and 9 patients had grade 4 lesions. The lesions healed in 19 patients (58%). All 10 patients (100%) with plantar lesions healed, while 7 (44%) of the patients with ischaemic lesions on the toes underwent lower leg amputation ( p < 0.01). Other factors that were important in determining which patients underwent amputation included the presence of local pain ( p < 0.001), and ankle/arm pressure index (<0.5 vs ≥ 0.5, p < 0.001). We conclude that plaster cast treatment is more useful in the treatment of advanced foot lesions than has previously been reported.