Effective and Economic Offloading of Diabetic Foot Ulcers in India with the Bohler Iron Plaster Cast.
Economic constraints are a major obstacle to the implementation of offloading casts in India. The aim of this study is to monitor the healing and activity limitations related to Bohler iron plaster cast (BIPC) when used for offloading diabetic neuropathic plantar foot ulcers. Thirty patients were cast for 1 month and evaluated for healing using the Pressure Ulcer Scale for Healing (PUSH), and for activity limitation using the Lower Extremity Functional Scale (LEFS). The change in the scores after intervention was the outcome measure. There was good healing as evidenced by a statistical difference in mean PUSH scores. The baseline PUSH score of 9.76-0.41 (T1-SEM) was greater than follow-up PUSH score of 6.32 + 0.41 (T2 + SEM) and the p value <0.0001. Improvement was seen in ulcer area, exudate, and tissue type. There was no mobility effect as there was no significant difference in LEFS. Significant negative correlation was there between PUSH and LEFS. The r value was less than -0.7 both at baseline and after intervention. The combined benefits of good healing, lack of affect on lower extremity function, the ease of application and dressing, and relative affordability make BIPC a commendable offloading modality for the management of diabetic plantar ulcers.
Department of Physical Medicine and Rehabilitation, All India Institute of Physical Medicine & Rehabilitation (AIIPMR), Haji Ali, Mahalaxmi, Mumbai, 400034 Maharashtra India ; Department of Physical Medicine and Rehabilitation, St. John's Medical College & Hospital, Sarjapur Road, Bengaluru, 560034 Karnataka India.
Priyanka
P
Saikia
Department of Physical Medicine and Rehabilitation, St. John's Medical College & Hospital, Sarjapur Road, Bengaluru, 560034 Karnataka India.
Rajalakshmi
R
Hariharan
Department of Anatomy, St. John's Medical College and Hospital, Sarjapur Road, Bengaluru, 560034 Karnataka India.
Nachiket
N
Shankar
Department of Physical Medicine and Rehabilitation, All India Institute of Physical Medicine & Rehabilitation (AIIPMR), Haji Ali, Mahalaxmi, Mumbai, 400034 Maharashtra India.
Anil Kumar
AK
Gaur
Department of Physical Medicine and Rehabilitation, St. John's Medical College & Hospital, Sarjapur Road, Bengaluru, 560034 Karnataka India.
Naveen Matthew
NM
Jose
Bohler iron plaster cast; Diabetic foot ulcers; Lower extremity function; Neuropathic ulcer healing; Offloading; Total contact cast