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Reducing pressure on the foot ulcer and wound

Reducing pressure on the foot can be done using other areas of pressure load from the foot and also using the lower limb to take pressure away from the foot also. The more surface area that can contact a support device such as an orthotic or leg cast, the less impact on the wounded and ulcered area.

For example, if there is an ulcer underneath the foot an orthotic will reduce the pressure in that area let’s say by 5%. This is very good for off-loading an area with a corn. It will stop it growing back from the high intensity of weight in this particular area. If the pressure is too severe in a particular place then there will be a wound or an ulcer. In this case we need to use more skin surface area to reduce the stress on the overloaded area even further. This is when we would implement a total contact cast from the knee to the foot to reduce the pressure on the foot greatly.

We can imagine it like holding a vase if you hold a vase from underneath all the pressure is solely on the bottom of the vase. If you hold the vase at the sides like a total contact cast does on the sides of the shin and calf muscles then the pressure is greatly reduced when you place the vase on the table. Similarly if you hold the lower leg at the sides and front, the pressure on the foot is much reduced. That’s why we use the total contact cast to reduce the stress on the foot. A corn can be reduced by using an orthotic as this will reduce the load by 5%. A wound has to be reduced by minimum 30% pressure using below the knee cast or an air cast.

 

 


6 comments

  • Edward Branson

    June 23, 2018 at 9:57 am

    My sister in law has an ulcer on her foot that will not heal. She had a car accident 30 years ago and her left leg had a lot of surgery. Her left foot looks very different to the right foot. I will show her your diagram as she only has an insole and this looks like she has to wear something more? Like a leg brace?

    Reply

    • Dubai Podiatry Centre

      June 23, 2018 at 12:52 pm

      Dear Edward,
      Yes a total contact cast helps to reduce pressure to the sole of the foot – just like reducing the pressure to the base of a vase when setting it down on a table. Sometimes there can be wounds and ulcers on areas of the foot when some of the muscles are imbalanced in the leg. If there has been damage to the doral foot muscles the plantar foot muscles in the sole of the foot contract and cause a much higher arched foot. .The higher the arch of the foot the more pressure on the forefoot and heel. If the foot was completely flat there is better weight distribution. Best wishes, Dubai Podiatry Centre

      Reply

  • Jeremy Stokes

    June 23, 2018 at 7:02 pm

    I’ve had an ulcer for 3 years unther my left metatarsal head and have a high are from muscle atrophy following a motorbike accident in my early 20s. I’m 64 now and have been considering amputation but I think I will try this total contact cast to help take some pressure away from the ulcer. They say my blood circulation is fine.

    Reply

    • Dubai Podiatry Centre

      September 2, 2018 at 11:57 am

      Yes try the total contact cast and also see podiatrist that may help with load distribution through your feet.

      Best wishes, DPC

      Reply

  • Aimee Taguna

    June 25, 2018 at 1:09 am

    My mother has hi blood sugar she is in Manila and has an ulcer in her foot. Would this help her? Aimee

    Reply

    • Dubai Podiatry Centre

      September 2, 2018 at 11:55 am

      Dear Aimee, yes this can help change the pressure on the foot. Please make sure your mother asunder the care of her Doctor first before using it. Healthy regards DPC

      Reply

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