PRACTICAL GUIDE The Total Contact Cast (TCC) can be used for the bloodless treatment of neuropathic plantar ulcers and has good results in their closure. It is an easy-to-perform, low-cost, low-morbidity method that allows walking with full weight bearing without walking aids. This guide helps orthopedic professionals understand the disease and make the TOTAL CONTACT CAST with quality and efficiency, reducing the risk of amputations and infections.
DIABETIC FOOT / CHARCOT ARTHROPATHY / PLANTAR INJURY /
TOTAL CONTACT CAST
FRANCISCO SÉRGIO DE OLIVEIRA
First, I thank God for allowing me the opportunity to do this work, it was a lot of work to research everything there is in the world on the subject with the intention of enabling professionals who care for orthopedic patients with problems caused by diabetes. To my children and grandchildren who are the reason for my existence and it's for them that I wake up every morning. I thank the friends who readily volunteered to help with the translations of the work: Mr. Charles Barocas CEO of the American Society of Orthopedic Professionals - USA Allen Garita Orthopedic Technologist San Jose - Costa Rica Massimo Menchella Nurse, Santi cosma and damiano - Italy
dream on dream until your dream come true (Aerosmith)
A thousand will fall at your side, and ten thousand at your right hand, but it will not come to you. Psalm 91:7
Francisco Sérgio de Oliveira graduated in nursing in 1993, graduated as a orthopedic technician in 1994 from the Brazilian Society of Orthopedics and Traumatology and a orthopedic technologist from the American Society of Professionals in Orthopedics in 2016. Specialist in Trauma Nursing by the Brazilian Nursing Association, specialist in cardiac surgery perfusion by the Santa Lucinda hospital, specialist in endoscopic procedures by Olympus and by Santa Casa de São Paulo. Master Caster by the American Society of Orthopedic Professionals - ASOP He has worked for 28 years at Sorocaba Hospital Center as an orthopedic technician in an orthopedic clinic.
INDEX
Introduction (Charcot's Neuropathy) ----------------------------------------------------------- 02 Types of Neuropathies ------------------------------------------------------------------------------- 03 Causes / risk factors / symptoms of neuropathies ----------------------------------------- 04 Pathogenesis -------------------------------------------------------------------------------------------- 07 Clinical presentation and diagnosis ------------------------------------------------------------- 08 Loss of protective sensation and deformities with and without ulcer -------------- 09 Classification (clinical and anatomical) --------------------------------------------------------- 12 Conclusion ------------------------------------------------------------------------------------------------ 14 Neuropathic plantar ulcers ------------------------------------------------------------------------- 15 Skin Anatomy and Physiology --------------------------------------------------------------------- 16 Healing Process ----------------------------------------------------------------------------------------- 17 Factors that interfere with healing --------------------------------------------------------------- 18 Ulcers (classification) --------------------------------------------------------------------------------- 19 Neurotrophic Ulcer ------------------------------------------------------------------------------------ 20 Application of full contact plaster in neuropathic ulcers --------------------------------- 22 Indications and technique of the total contact plaster ----------------------------------- 26 Indications / contraindications -------------------------------------------------------------------- 29 Ulcer evaluation / debridement / dressings -------------------------------------------------- 31 Characteristics of an ideal dressing / Ulcer cleaning / Coverings --------------------- 33 Main types of roofs ------------------------------------------------------------------------------------ 34 Technique of making full contact plaster ------------------------------------------------------ 36 Iatrogenic complications the full contact plaster ------------------------------------------- 40 References ----------------------------------------------------------------------------------------------- 41
INTRODUCTION
Charcot's Neuroarthropathy (CNA) Charcot neuroarthropathy (CNA) is a bone and joint deformity of the neuropathic foot, in which the architecture and structural organization of the bones are altered, with radiographic alterations characterized by bone destruction and remodeling, joint destruction, subluxation and dislocation.
Despite recognizing that Mitchell was the first physician to describe osteoarticular destruction associated with neurological dysfunction, it was Charcot who, in 1868, made the first detailed histopathological description of the alterations present in Tabes Dorsalis. In 1881, Paget, at an international medical congress in London, suggested the definition of Charcot's disease for this pathological entity that has several definitions.
Although Diabetes is currently the main cause of CNA worldwide, it was only in 1936 that this pathology was described for the first time as a complication of Diabetes. Although recognized for over 300 years, CNA remains a complex and difficult entity when it comes to diagnosis and treatment. Therefore, healthcare professionals should be aware of this pathology given the growing trend of Diabetes and its complications.
Diabetic neuropathy is a nervous disorder caused by diabetes. People with the disease can, over time, experience nerve damage throughout the body. Some people may not have any symptoms, others may experience pain, tingling or loss of sensation especially in the hands, arms, feet and legs. However, these problems can also occur in the digestive system, heart and reproductive organs.
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