Felted Foam Total Contact Padding for a Neuropathtic Foot Wound

TOPIC:  Offloading to redistribute pressure is a basic principle in healing diabetic and neuropathic foot ulcers.  Options for offloading include bed rest, wheelchairs, crutches, surgical shoes, custom sandals, removable cast walkers, felted foam dressings, orthotics, and orthopedic footwear. The total contact cast (TCC) is considered the gold standard for offloading foot wounds. A TCC, however, is contraindicated in patients with acute deep tissue infection, sepsis, or gangrene.  Other relative contraindications include patients with fragile skin, excessive edema, noncompliance issues, and those who would be unstable with a cast.  Felted foam dressings have been shown to provide the offloading benefits of a TCC while allowing appropriate management of patients. PURPOSE:  The purpose of this poster is to show the step by step application of a felted foam dressing for use in an outpatient wound clinic.

OBJECTIVES:

1. Demonstrate application of the felted foam dressing
2. Describe the plan of care
3. Explain the patient teaching and education

OUTCOME:  The use of felted foam dressings in comparison to TCC reduces application time, increases patient comfort and ease of movement, reduces the chance of secondary lesions, and is cost effective.

REFERENCES:

Bryant, R, Nix, D.  (2007).  Acute & Chronic Wounds: Current Management Concepts. (Rev. ed.). St. Louis, MO: Mosby.

Cantanzariti, A. A. (2011).  Off-loading techniques in the treatment of diabetic plantar neuropathic foot ulceration.  October 25, 2011.