This study compared the treatment of total contact casting (TCC) with traditional dressing treatment (TD) in the management of neuropathic diabetic plantar ulcers. Thirty-one patients with plantar ulcers without any gross infection, osteomyelitis or gangrene were randomly assigned to the TCC group (n ¼ 15) or TD group (n ¼ 16). In the experimental group, TCC was applied on the initial visit and subjects were instructed to limit ambulation to one-third of their usual activity. Subjects in the control group (TD) were prescribed dressing changes and were advised against bearing weight on the involved extremity. Ulcers were considered healed if they showed complete skin closure with no drainage. Ulcers were considered not healed if they showed no decrease in size by 6 weeks or if infection developed requiring hospitalization. In the TCC group, 12 of 15 ulcers healed in 48 + 7 days; in the TD group, 10 of 16 ulcers healed in 58 + 9 days. Comparatively higher rate of ulcer healing with fewer infections was seen in the TCC group. We conclude TCC is a more effective method than dressing for treating diabetic plantar ulcers reducing the risks of amputation.
Pneumatic tourniquets have been used in orthopaedic surgery to get avascular fields. Sixteen such tourniquets were analysed for microbial colonisation. Samples were taken from two inner and two outer areas of each tourniquet and cultured on sheep blood agar. Eight of these were wiped with Savlon and the rest with Sterillium solution. Post-treatment samples from the same sites were again cultured. After incubation, colonies from each site were identified and counted. It was observed that the tourniquets were colonised with coagulase-negative staphylococci, Staphylococcus aureus, Bacillus, diphtheroids, Pseudomonas, Acinetobacter, enterococci, enterobacteria, and Candida. On treating with Savlon and Sterillium, there was 92.18% and 95.70% reduction in the colony count, respectively.
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