Provision of appropriate offloading devices, such as the below knee total contact cast with Bohler iron (TCCBI), or the moulded double rocker shoe (MDRS), to protect patients with ulcers, has always been a vital component of leprosy control programs. These offloading devices are options to help in healing plantar ulcers. The disadvantages of the existing devices are that they are heavy and cumbersome to wear and prevent the individual from performing their daily activities.
A two-year cross sectional study was carried out at a tertiary leprosy referral centre in India. All the leprosy affected patients provided with the TCCBI as a treatment option for healing their plantar ulcers were included in the study. The patients (n = 54) were aged between 20 and 81 years. The plasters were applied until the ulcer was healed or had reduced in size. All the patients were admitted while using the TCCBI.
The patients who used the TCCBI were able to function and walk without any difficulty. Most users (94%) said that the TCCBI helped in healing the ulcers. In regard to comfort and functionality, 72% and 57% of users, respectively, were apprehensive about wearing the TCCBI continuously. Most users (63%) felt embarrassed to use the TCCBI every day, even in the hospital setting.
The study re-emphasizes the value of the TCCBI in healing plantar ulcers. However, both acceptance and functionality of the TCCBI needs to be studied further and the development of less cumbersome devices is encouraged.
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