{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T14:44:05Z","timestamp":1789656245656,"version":"4.0.1"},"reference-count":28,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2014,2,21]],"date-time":"2014-02-21T00:00:00Z","timestamp":1392940800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"name":"National Institute of Health, National Institute of Diabetes and Digestive and Kidney Diseases","award":["2R44 DK 56571-02"],"award-info":[{"award-number":["2R44 DK 56571-02"]}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["International Wound Journal"],"published-print":{"date-parts":[[2015,12]]},"abstract":"Abstract<\/jats:title>The objective of this study was to evaluate the efficacy of three off\u2010loading techniques to heal diabetic foot wounds: total contact casts (TCC<\/jats:styled-content>s), healing sandals (HS<\/jats:styled-content>s) and a removable boot with a shear\u2010reducing foot bed (SRB<\/jats:styled-content>). This was a 12\u2010week, single\u2010blinded randomised clinical trial with three parallel treatment groups of adults with diabetes and a foot ulcer (n<\/jats:italic> = 73). Ulcer healing was defined as full reepithelialisation with no drainage. Diabetic patients with grade UT1A<\/jats:styled-content> or UT2A<\/jats:styled-content> forefoot ulcers on the sole of the foot were enrolled. Patients with malignancy, immune\u2010compromising diseases, severe peripheral vascular disease (ankle\u2010brachial index < 0\u00b760 or transcutaneous oxygen < 25 mm\/Hg), alcohol or substance abuse within 6 months, untreated osteomyelitis or Charcot arthropathy with residual deformity that would not fit the HS<\/jats:styled-content> or boot were excluded. In the intent\u2010to\u2010treat analysis, significantly higher proportion of patients were healed in the TCC<\/jats:styled-content> group (69\u00b76%) compared to those treated with the SRB<\/jats:styled-content> (22\u00b72%, P<\/jats:italic> < 0\u00b705). There was no difference in the rate of healed ulcers in the HS<\/jats:styled-content> (44\u00b75%) and TCC<\/jats:styled-content> groups. Ulcers in the TCC<\/jats:styled-content> group healed faster than those in the HS<\/jats:styled-content> group (5\u00b74 \u00b1 2\u00b79 versus 8\u00b79 \u00b1 3\u00b75 weeks, P<\/jats:italic> < 0\u00b702). However, there was no difference in the time to healing in the TCC<\/jats:styled-content> and SRB<\/jats:styled-content> groups (6\u00b77 \u00b1 4\u00b73 weeks, P<\/jats:italic> = 0\u00b728). Patients who used HS<\/jats:styled-content> were significantly more active (4022 \u00b1 4652 steps per day, P<\/jats:italic> < 0\u00b705) than those treated with TCCs<\/jats:styled-content> (1447 \u00b1 1310) or SRB<\/jats:styled-content> (1404 \u00b1 1234). It is concluded that patients treated with TCCs<\/jats:styled-content> had the highest proportion of healed wounds and fastest healing time. The novel shear\u2010reducing walker had the lowest healing and highest rate of attrition during the study.<\/jats:p>","DOI":"10.1111\/iwj.12213","type":"journal-article","created":{"date-parts":[[2014,2,24]],"date-time":"2014-02-24T17:29:14Z","timestamp":1393262954000},"page":"710-715","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":78,"title":["Randomised clinical trial to compare total contact casts, healing sandals and a shear\u2010reducing removable boot to heal diabetic foot ulcers"],"prefix":"10.1111","volume":"12","author":[{"given":"Lawrence A","family":"Lavery","sequence":"first","affiliation":[{"name":"Department of Plastic Surgery University of Texas Southwestern Medical Center Dallas TX USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kevin R","family":"Higgins","sequence":"additional","affiliation":[{"name":"Private Practice San Antonio TX 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