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Focused rigidity cast (FRC) to offload plantar foot wounds

Discussion in 'Diabetic Foot & Wound Management' started by Faezah Sani, Feb 5, 2015.

  1. Faezah Sani

    Faezah Sani Welcome New Poster


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    I am currently working in Singapore and it's a norm for people to walk barefeet at home, which makes compliance to offloading devices such as walkers and shoes challenging.

    I came across FRC while doing a research on Martini cast. We have trialed it on one of our patients here and the result looks promising so far. We are still trying to figure out on how to optimise the fabrication of the device and there are currently not many papers or materials out there that describe the process.

    Was wondering if anyone has had any experience using such device and would like to share any tips and experiences?
     
  2. Craig Payne

    Craig Payne Moderator

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    :welcome: Faezah

    Can't say I had even heard of it, so had to Google it..... which probably also means that not many people are actually using it, so you are probably not going to get much of a response.
     
  3. WApod

    WApod Member

    Hi,
    I have used this kind of cast, we tend to call it a slipper cast though. It can be quite successful at offloading fore foot wounds however it is still removable by the patinet. I usually only chose this option if they can't have a full TCC or bi-valved TCC for some reason.

    The main issues / tips for this cast are:
    - Don't wrap the cast it too thick it can make it very difficult to get on and off.
    - Don't stretch the liner too much (use a bigger size than you expect) as it will split / come away from the edges and cur up inside.
    - Make sure the cast is cut down around the anterior ankle so the person doesn't get pinching / irritation as they dprsiflex. Pad up the edges with felt or foam and cover with fixomul / sports tape.
    - Keep the back of the heel as low as you can, again ensure he edges are padded.
    - Make sure the sole is flat, and the ankle at 90 when it's setting.
    - the patient should wait at least 20 mins before walking on it
    - A flat or rocker Darco can be fitted over the top to walk, it may need extended Velcro to close. They may require an even up for the other side.
    - They can last 6-8 weeks if made well and The liner can be replaced if needed.

    If you don't want the patient to remove the offloading and walk around without any offloading in place a football dressing could be a great option. The patient can remove the Darco and still have some offloading in place when walking around home. The football is easy to do with basic / cheap supplies and can be left in place for a week at a time. If the level of exudate is too much for that it can be changed more often, It's easy enough for community nurses to replace with step by step instructions.

    Good Luck!
     
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