About 1 in 10 people in Ontario have diabetes. Each year, about 2% to 3% of them develop a foot ulcer. Diabetic foot ulcers put people at risk for foot and lower leg amputation. Pressure offloading devices, which include fibreglass total contact casting, removable cast walkers, and irremovable cast walkers, are used to treat foot ulcers, but they are not routinely publicly funded in Ontario.
The objective of this report was to assess the clinical benefits and harms of fibreglass total contact casting, removable cast walkers, and irremovable cast walkers in people with diabetic foot ulcers. We compared these devices with each other and with therapeutic shoes. We looked at the cost-effectiveness of these devices and calculated the budget impact of publicly funding them. We also interviewed people who have used these devices to learn more about their experiences.