• Reference Number: HEY-373/2016
• Departments: Diabetes
• Last Updated: 1 June 2016

Introduction

This leaflet has been produced to give you general information about your treatment.  Most of your questions should be answered by this leaflet.  It is not intended to replace the discussion between you and your healthcare professional, but may act as a starting point for discussion.  If after reading it you have any concerns or require further explanation, please discuss this with a member of the healthcare team caring for you.

What is a heel cast?

          
A heel cast is a custom-made cup-shaped cast device that fits snugly to the shape of the heel. It is made from similar materials to those that are used to make casts for broken bones.

Why do I need a heel cast?

Heel casts are designed to treat foot ulcers which may be caused by friction and pressure. Continuing pressure can delay healing of any foot ulcer. Heel casts may help reduce friction and pressure on the ulcer site, which may help to heal the ulcer and reduce pain.

Can there be any complications or risks?

Although the cast is custom-made to fit your foot there is a possibility that the cast could rub. It is important to check the foot and cast regularly for signs of rubbing.

If the cast does rub you must stop using it immediately and contact the Diabetes Foot Protection Team for advice.

How is a heel cast made?

The ulcer will be dressed with an appropriate dressing. The cast is then made to fit snugly over this dressing. A thin stockinette bandage is used to cover the dressing and layers of casting tape are wrapped round the foot and dressing to create a close fitting cast. Once the cast tape has set it is cut and shaped into a heel cup.

How is a heel cast used?

The cast fits between the layers of the dressing and bandaging. It is made to fit the heel and dressing snugly so it is vital that an identical dressing is used at dressing changes. Your health care professional will discuss your dressings with you. The cast must not be put onto direct contact with the skin as this may cause rubbing. A thin layer of tubular bandage should be used to hold the cast in place and prevent it from moving and rubbing. A special sandal will be used over the bandaging as it is too large to fit into ordinary footwear.

The cast can be re-used many times before it needs to be replaced. It is vital that the cast is re-applied at every dressing change to continue to keep the friction and pressure away from the ulcer. It is also important to check the fit of the cast at each dressing change and to make sure that it is not rubbing.

Remember – Seek medical advice as soon as possible if you notice any change to the foot such as:

• Rub marks from the cast.
• Swelling.
• Redness.
• Increase in pain.
• Increase in the amount of fluid coming from the ulcer.
• Hot or cold sweats or flu-like symptoms develop.

Should you require further advice on the issues contained in this leaflet, please do not hesitate to contact:

Diabetes Foot Protection Team, The Diabetes Centre.
Telephone number: (01482) 675345. Monday to Friday 8:30am to 5:00pm.

General Advice and Consent

Most of your questions should have been answered by this leaflet, but remember that this is only a starting point for discussion with the healthcare team.

Consent to treatment

Before any doctor, nurse or therapist examines or treats you, they must seek your consent or permission. In order to make a decision, you need to have information from health professionals about the treatment or investigation which is being offered to you. You should always ask them more questions if you do not understand or if you want more information.

The information you receive should be about your condition, the alternatives available to you, and whether it carries risks as well as the benefits. What is important is that your consent is genuine or valid. That means:

• you must be able to give your consent
• you must be given enough information to enable you to make a decision
• you must be acting under your own free will and not under the strong influence of another person

Information about you

We collect and use your information to provide you with care and treatment. As part of your care, information about you will be shared between members of a healthcare team, some of whom you may not meet. Your information may also be used to help train staff, to check the quality of our care, to manage and plan the health service, and to help with research. Wherever possible we use anonymous data.

We may pass on relevant information to other health organisations that provide you with care. All information is treated as strictly confidential and is not given to anyone who does not need it. If you have any concerns please ask your doctor, or the person caring for you.

Under the General Data Protection Regulation and the Data Protection Act 2018 we are responsible for maintaining the confidentiality of any information we hold about you. For further information visit the following page: Confidential Information about You.

If you or your carer needs information about your health and wellbeing and about your care and treatment in a different format, such as large print, braille or audio, due to disability, impairment or sensory loss, please advise a member of staff and this can be arranged.