Wound Care, Tissue Repair & Regenerative Medicine

Biography

Biography: Maria Shaw

Abstract

Statement of the Problem: Chronic foot ulcers are growing concern worldwide, in particular diabetic foot ulcers. Th e combination of neuropathy and exudate, causing maceration, inhibits eff ective healing. Previously, a total contact cast would be used to off load patients with chronic foot ulcers, a window would be cut into the cast to access the wound for dressing change. However, when heavy exudate is present the dressings and the cast need to be replaced. Ulcers improve with this method but usually take over a year or more to heal. Th e numerous dressing, and cast changes has a substantial cost to the DHBs and a signifi cant impact on a patient’s quality of life. Methodology & Th eoretical: As with most chronic ulcers, there is a degree of neuropathy keeping the feet cold and with limited feeling. Changing from using synthetic casting, to a Soft offl oading bandage (SLb), has seen a marked reduction in healing times for these ulcers. SLb included plaster stocking, soft ban, crepe bandages, and a Moonboot or DARCO shoe. Th is kept the foot warm and offl oaded at the same time. Th ere were a total of seven chronic ulcers seen within a year and fi ve out of the seven ulcers healed within three to six months. Th e 6th was healing well but due to unstable co-morbidities, the client was removed from the study. Th e 7th client had chronic osteomyelitis, and was also removed from the study. Conclusion: By simply altering the off -loading technique and keeping the foot warm resulted in faster healing rates for chronic ulcers. Although not suitable for all patients, there was a signifi cant reduction in the time frame for healing ulcers; this had a positive impact on the patient’s quality of life and a marked reduction in costs to the DHB.