Setting up a total contact casting service within a diabetes foot ulcer service
Published Date: 07th October 2020
Publication Authors: Pendlebury H, Furlong NJ, Sullivan H
Aims
The National Institute for Health and Care Excellence (NICE) recommend total contact casting (TCC) for neuropathic ulceration in the diabetic foot. The St Helens and Knowsley Hospitals Trust, Diabetes Team, determined the feasibility of starting and developing a TCC service within their diabetes foot ulcer service.
Method
The type of TCC available was explored from July 2018. Room availability was determined. Capacity and competency of staff was developed. Standards, Pathways and paperwork established. Suitable patients and foot type were identified in December 2018. First patient was casted in January 2019. Service commenced and monitored
Results
TCC development work began in July 2018. The TCC service was commenced in January 2019. Five patients were identified for TCC. Three patients have received TCC since commencing casting service and remain healed after six weeks. One patient required Tendon Achilles lengthening prior to casting and ulcer remains intact. One patient stopped TCC due to infection and healed with removable walker boot. Staff training and competency constantly reviewed and developed. TCC Service development can take one year to establish. The cost effectiveness and evaluation of TCC service remains ongoing.
Conclusions
TCC benefits patients but the practicalities in setting up a TCC service can be challenging. This service highlights the actions required to establish a TCC service. One year for establishment of a TCC service must be taken into consideration.
Pendlebury, H; Furlong, N; Sullivan, H. (2020). Setting up a total contact casting service within a diabetes foot ulcer service. Diabetic Medicine. 37 (S1), 120