Removable Walker for Neuropathic Ulcers

NCT ID: NCT01005264

Last Updated: 2009-10-30

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

PHASE3

Total Enrollment

48 participants

Study Classification

INTERVENTIONAL

Study Start Date

2008-02-29

Study Completion Date

2009-03-31

Brief Summary

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1. Objective: To evaluate the efficacy of removable cast walker compared to non-removable fiberglass off-bearing cast in the treatment of diabetic plantar foot ulcer
2. Research design and methods: Forty-five adult diabetic patients with non-ischemic, non-infected neuropathic plantar ulcer were randomized to treatment with a non-removable fiberglass off-bearing cast (TCC group) or walker cast (Stabil-D group). Treatment duration was 90 days. Percent reduction in ulcer surface area and total healing rates were evaluated after treatment.

Detailed Description

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Study design:

Two centers specializing in diabetic foot management (located in Sesto S. Giovanni and Milan, Italy) participated to this open, randomized clinical trial. The ethics-committee approved the study on January 10th, 2008. Enrollment of consecutive patients began February 2008 and ended March 2009. Eligible patients were fully informed of the study aim and procedures and written consent was obtained prior to study participation. Patients were then randomly assigned to one of the two treatment groups by opening randomization codebreak envelopes containing one of the two options. Separate randomization was performed for each center, and a copy of all randomization envelopes was kept at the statistical department of the Multimedica center. The two arms were composed of patients managed with non-removable fiberglass off-bearing cast (TCC group) and patients offloaded with the Stabil-D® (Podartis srl, Montebelluna, Treviso, Italy) walker cast (Stabil-D group).

Conditions

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Diabetic Foot

Keywords

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diabetic foot neuropathic plantar ulcer ulcer healing non-removable total contact cast removable cast walker

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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non-removable fiberglass

Softcast3M®, 3M Health Care, St. Paul, MN (USA) were used for construction of the pressure-relief apparatus

Group Type ACTIVE_COMPARATOR

non-removable fiberglass

Intervention Type DEVICE

Two types of fiberglass bandages (Softcast3M®, 3M Health Care, St. Paul, MN (USA)) were used for construction of the pressure-relief apparatus

Stabil-D®

Composed of a specifically designed rigid, boat shaped, and fully rocker bottom sole

Group Type ACTIVE_COMPARATOR

Stabil-D®

Intervention Type DEVICE

Stabil-D Stabil-D® is composed of a specifically designed rigid, boat shaped, and rocker sole

Interventions

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non-removable fiberglass

Two types of fiberglass bandages (Softcast3M®, 3M Health Care, St. Paul, MN (USA)) were used for construction of the pressure-relief apparatus

Intervention Type DEVICE

Stabil-D®

Stabil-D Stabil-D® is composed of a specifically designed rigid, boat shaped, and rocker sole

Intervention Type DEVICE

Other Intervention Names

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Softcast3M®, 3M Health Care, St. Paul, MN (USA) Podartis srl, Montebelluna, Treviso, Italy

Eligibility Criteria

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Inclusion Criteria

* The presence of neuropathic plantar ulcer with an area graded IA according to the Texas University classification, AND
* The presence of peripheral neuropathy. Peripheral neuropathy was diagnosed based on insensitivity to a 10-g Semmes-Weinstein monofilament in more than 6 out of 9 areas of the foot and by a vibration perception threshold measured by biothesiometer (Neurothesiometer SLS, Nottingham, UK) at the malleolus \> 25 volts.

Exclusion Criteria

* Presence of an ankle-brachial pressure index (ABI) \< 0.9 and/or transcutaneous oxygen tension (TcPO2) \< 50 mmHg tested on the dorsum of the foot,
* Presence of clinical signs of infection, including edema, erythema, increased local skin temperature, or drainage,
* The probe-to-bone maneuver was required to be negative,
* Tthe standard X-ray examination of the foot was required to be negative for osteomyelitis,
* Use of steroids or cytostatic drugs,
* Presence of sensory, motor, or visual problems that could impair functional autonomy,
* Active ulcer on the contralateral foot,
* Previous major amputation of the contralateral limb,
* Previous or current deep venous leg thrombosis, OR
* Mental disorders interfering with patient compliance.
Minimum Eligible Age

18 Years

Maximum Eligible Age

80 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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IRCCS Multimedica

OTHER

Sponsor Role lead

Responsible Party

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Diabetic Foot Center - IRCCS Multimedica, Sesto San Giovanni (Milan), Italy

Principal Investigators

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Ezio Faglia, MD

Role: PRINCIPAL_INVESTIGATOR

Diabetic Foot Center - IRCCS Multimedica, Sesto San Giovanni (Milan), Italy

Locations

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Diabetic Foot Center - IRCCS Multimedica

Sesto San Giovanni, Milan, Italy

Site Status

Countries

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Italy

References

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Caravaggi C, Sganzaroli A, Fabbi M, Cavaiani P, Pogliaghi I, Ferraresi R, Capello F, Morabito A. Nonwindowed nonremovable fiberglass off-loading cast versus removable pneumatic cast (AircastXP Diabetic Walker) in the treatment of neuropathic noninfected plantar ulcers: a randomized prospective trial. Diabetes Care. 2007 Oct;30(10):2577-8. doi: 10.2337/dc07-0990. Epub 2007 Jun 11. No abstract available.

Reference Type RESULT
PMID: 17563333 (View on PubMed)

Piaggesi A, Macchiarini S, Rizzo L, Palumbo F, Tedeschi A, Nobili LA, Leporati E, Scire V, Teobaldi I, Del Prato S. An off-the-shelf instant contact casting device for the management of diabetic foot ulcers: a randomized prospective trial versus traditional fiberglass cast. Diabetes Care. 2007 Mar;30(3):586-90. doi: 10.2337/dc06-1750.

Reference Type RESULT
PMID: 17327325 (View on PubMed)

Caravaggi C, Faglia E, De Giglio R, Mantero M, Quarantiello A, Sommariva E, Gino M, Pritelli C, Morabito A. Effectiveness and safety of a nonremovable fiberglass off-bearing cast versus a therapeutic shoe in the treatment of neuropathic foot ulcers: a randomized study. Diabetes Care. 2000 Dec;23(12):1746-51. doi: 10.2337/diacare.23.12.1746.

Reference Type RESULT
PMID: 11128345 (View on PubMed)

Faglia E, Caravaggi C, Clerici G, Sganzaroli A, Curci V, Vailati W, Simonetti D, Sommalvico F. Effectiveness of removable walker cast versus nonremovable fiberglass off-bearing cast in the healing of diabetic plantar foot ulcer: a randomized controlled trial. Diabetes Care. 2010 Jul;33(7):1419-23. doi: 10.2337/dc09-1708. Epub 2010 Mar 31.

Reference Type DERIVED
PMID: 20357377 (View on PubMed)

Other Identifiers

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05/2007cardiovascolare

Identifier Type: -

Identifier Source: org_study_id