Instant Total Contact Cast to Heal Diabetic Foot Ulcers

NCT ID: NCT01221207

Last Updated: 2020-08-24

Study Results

Results available

Outcome measurements, participant flow, baseline characteristics, and adverse events have been published for this study.

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Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

225 participants

Study Classification

INTERVENTIONAL

Study Start Date

2010-10-31

Study Completion Date

2012-10-31

Brief Summary

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Aim 1. To compare the effectiveness of total contact casts (TCC), removable cast walkers (RCW) and instant total contact casts (ITCC) to heal diabetic foot ulcers in a 20 week randomized clinical trial of 225 patients in community care in three university medical center diabetes clinics.

Aim 2. To compare the frequency of complications such as soft tissue and bone infections, iatrogenic wounds, falls and fall related injuries, and amputations among patients treated with TCC, ITCC and RCW to heal diabetic foot ulcers.

Aim 3. To compare patient compliance and level of activity among TCC, ITCC, RCW treatment groups. Using computerized activity monitors which time-stamp each step, we will evaluate both degree and magnitude of activity between groups.

Aim 4. To evaluate the cost of diabetic foot ulcer-related treatment and complications during the course of therapy.

Detailed Description

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This is an investigator blinded randomized, controlled clinical trial with three parallel treatment groups of 75 adult outpatients with diabetes mellitus and a foot ulcer. The study will be conducted at five university affiliated medical centers in Arizona and Texas. The study participants and nurse coordinator will not be blinded to the treatment after randomization. Investigators will be blinded to treatment group assignment.

Conditions

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Diabetic Foot Ulcers

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

SINGLE

Investigators

Study Groups

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Device - Total Contact Cast (TCC)

A total contact cast (TCC) is a special cast technique that is used to take the pressure and shear stress off the ulcer to assist in the healing.

Group Type ACTIVE_COMPARATOR

Total Contact Cast

Intervention Type DEVICE

A total contact cast (TCC) is a special cast technique that is used to take the pressure and shear stress off the ulcer to assist in the healing.

Removable Cast Walker (RCW)

The removable cast walker (RCW) is a commercial product that is similar to a cast. It is secured with Velcro straps around the foot and leg and it is also effective at removing the pressure and shear stress on the foot.

Group Type ACTIVE_COMPARATOR

Removable Cast Walker (RCW)

Intervention Type DEVICE

The removable cast walker (RCW) is a commercial product that is similar to a cast. It is secured with Velcro straps around the foot and leg and it is also effective at removing the pressure and shear stress on the foot.

Instant Total Contact Cast (ITCC)

The instant total contact cast (ITCC) is a technique that uses the removable cast walker, but secures it so it cannot be removed between clinic visits and evaluation by the subject or the physician.

Group Type ACTIVE_COMPARATOR

Instant Total Contact Cast (ITCC)

Intervention Type DEVICE

The instant total contact cast (ITCC) is a technique that uses the removable cast walker, but secures it so it cannot be removed between clinic visits and evaluation by the subject or the physician.

Interventions

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Total Contact Cast

A total contact cast (TCC) is a special cast technique that is used to take the pressure and shear stress off the ulcer to assist in the healing.

Intervention Type DEVICE

Instant Total Contact Cast (ITCC)

The instant total contact cast (ITCC) is a technique that uses the removable cast walker, but secures it so it cannot be removed between clinic visits and evaluation by the subject or the physician.

Intervention Type DEVICE

Removable Cast Walker (RCW)

The removable cast walker (RCW) is a commercial product that is similar to a cast. It is secured with Velcro straps around the foot and leg and it is also effective at removing the pressure and shear stress on the foot.

Intervention Type DEVICE

Eligibility Criteria

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Inclusion Criteria

* Men or women 18 years old or older
* One or more foot ulcers without clinical evidence of osteomyelitis
* Diagnosis of Diabetes Mellitus
* University of Texas Grade 1A-B, 2A-B or 3A-B
* ABI \>0.5
* Spanish-speaking subjects will be eligible to participate

Exclusion Criteria

* Active Charcot Arthropathy
* ABI \<0.5
* Gangrene, active infection
* Unable to keep research appointments
* Wide spread malignancy or systemically immunocompromising disease
* Alcohol or substance abuse within 6 months
* Unreliable, unwilling or unable to comprehend informed consent
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)

NIH

Sponsor Role collaborator

University of Texas Southwestern Medical Center

OTHER

Sponsor Role lead

Responsible Party

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Larry Lavery

Professor

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Lawrence Lavery, DPM

Role: PRINCIPAL_INVESTIGATOR

UT Southwestern Medical Center at Dallas

Locations

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University of Arizona

Tucson, Arizona, United States

Site Status

Parkland Health & Hospital Systems

Dallas, Texas, United States

Site Status

UT Southwestern Medical Center at Dallas

Dallas, Texas, United States

Site Status

Scott & White

Temple, Texas, United States

Site Status

Countries

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United States

Other Identifiers

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UTSW - 7R01DK074483-04

Identifier Type: -

Identifier Source: org_study_id

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