Total contact casts should have an absolute minimum of padding, so that the
cast does not 'open-up' and allow increased movement around the leg and
foot.
Therefore, as you described, a strip of felt down the tibial crest, some
minor padding around the malleoli, and some foam around the toes (if you
follow the closed-toe technique) is all that is required.
Apply a thin dressing (nothing fancy) over the ulcer, apply stockinette,
apply a layer of plaster evenly without ridges, then do the rest with
fibreglass.
The greater the conformity of the initial plaster layer the better, too much
underpadding will allow movement and friction lesions.
Hope this helps.
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ANTHONY SHORT
Podiatrist
Queensland Diabetes Centre at the Mater
Private Practice:
Taylor Medical Centre
Suite 8, 40 Annerley Road
Woolloongabba QLD 4102
AUSTRALIA
Ph: + 61 7 3391 3900
Fax: + 61 7 3844 7100
E-Mail: [log in to unmask]
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