Use of the 'Scotchcast boot' in treating diabetic foot ulcers

Abstract

Healing of diabetic foot ulceration is helped by reducing pressure on the affected foot in bed or with a plaster of Paris cast with a window cut out over the lesion. These casts are, however, heavy and fragile when wet, needing frequent reapplication. We investigated the use of a Scotchcast as a substitute for plaster of Paris because of its lightness and high integral strength. Treatment with the Scotchcast boot allows the diabetic patient with foot ulceration to be managed primarily as an outpatient and to continue to be a useful member of the community. The treatment is relatively cheap because it avoids expensive inpatient care. The technique does, however, need the skills of a highly trained plaster technician or nurse. The disadvantages of the Scotchcast boot compared with the more conventional plaster of Paris cast is that the edges are sharp and, if applied without care, may damage otherwise healthy skin.