1. Immobilization – Cast Boot
The cast boot is a low cost and effective tool to remove pressure from the wound. What are the pitfalls commonly encountered in the use of the cast boot?
a. Right type? What is the purpose?
- To reduce pressure on the forefoot – need rocker sole and knee high
- To immobilize the ankle – rocker sole less important
- Removable or non-removable options
b. Right size? How to apply?
- Too small is common – no pressure on delicate wound tissue! Extra wide and long enough that toes are well protected
- The heel should not lift as that means further friction.
- Fitting tips.
c. Correct for height difference
d. Footbed Modification
Your wound specialist team may determine that special modifications to the insole of the cast boot is needed.
2. Immobilization – Total Contact Cast
This is considered the gold standard for protection of the foot while healing a wound.
Free and low-cost access by Ontario residents to this wonderful tool has recently been supported by the Ontario government.
3. Protective Sandals
There are a variety of specialized sandals to consider – depending upon the location of the ulcer.