title: Total contact casting as part of an adaptive care approach: a case study.
abstract: Although total contact casting provides pressure relief and a moist wound-healing modality that allows patients to resume mobility while the wound is healing, it is not as widely used as it should be, in part because Board-certified pedorthists with relevant skills are scarce. As a result, clinicians may not appreciate the positive impact total contact casting has on the patient's overall condition. This case study of a 75-year-old woman with a potentially life-threatening diabetic foot ulcer offers a comprehensive picture of pervasive physiological changes in a context of challenging comorbidities. This multifaceted case is presented against a backdrop of Sister Callista Roy's nursing theory of adaptation and a total patient care approach to illustrate the cascading effects of diabetes on the patient's well-being, as well as to show that total contact casting is not only an effective intervention in the management of the patient's diabetic foot ulcer, but also a way to improve the patient's overall condition by maximizing the benefits of mobility.
authors.affiliation: Staten Island University Hospital, New York, NY, USA. karen_farid@siuh.edu
authors.forename: Karen
authors.initials: K
authors.lastname: Farid
authors.forename: Mark
authors.initials: M
authors.lastname: Farid
authors.forename: Claire M
authors.initials: CM
authors.lastname: Andrews
mesh_terms: D000222:Adaptation, Physiological; D000368:Aged; D002370:Casts, Surgical; D017719:Diabetic Foot / Q000150:complications / Q000534:rehabilitation / Q000628:therapy*; D005260:Female; D005531:Foot Deformities, Acquired / Q000209:etiology* / Q000534:rehabilitation; D006801:Humans; D051346:Mobility Limitation; D008962:Models, Theoretical; D012559:Schizophrenia / Q000150:complications*; D014945:Wound Healing