Total contact casting as part of an adaptive care approach: a case study

Although total contact casting provides pressure relief and a moist wound-healing modality that allows patients to resume mobility while the wound is healing, it is not as widely used as it should be, in part because Board-certified pedorthists with relevant skills are scarce. As a result, clinicians may not appreciate the positive impact total contact casting has on the patient's overall condition. This case study of a 75-year-old woman with a potentially life-threatening diabetic foot ulcer offers a comprehensive picture of pervasive physiological changes in a context of challenging comorbidities. This multifaceted case is presented against a backdrop of Sister Callista Roy's nursing theory of adaptation and a total patient care approach to illustrate the cascading effects of diabetes on the patient's well-being, as well as to show that total contact casting is not only an effective intervention in the management of the patient's diabetic foot ulcer, but also a way to improve the patient's overall condition by maximizing the benefits of mobility.