Wound, Ostomy and Continence Nurses Society (WOCN) Practice Exam

Which of the following best describes the effect of total contact casting on edema?

1. Increases swelling

2. Has no impact on swelling

3. Reduces edema with static compression

4. Only benefits superficial wounds

The correct answer is: Reduces edema with static compression

Total contact casting is an effective therapeutic intervention primarily used to manage lower extremity wounds, particularly in patients with diabetes and peripheral neuropathy. The mechanism by which total contact casting reduces edema involves the application of controlled static compression to the limb. When a total contact cast is applied, it distributes pressure evenly across the foot and lower leg. This pressure facilitates venous return, helping to reduce excess fluid accumulation in the tissues, which is typically present in cases of edema. The static compression provided by the cast aids in preventing fluid from pooling in the interstitial spaces, thus reducing swelling over time. Additionally, by immobilizing the affected area, total contact casting promotes proper alignment and minimizes movement, which can further contribute to fluid accumulation. The combination of these effects ultimately leads to a reduction in edema, making this method a preferred choice in the management of similar conditions. This intervention is not specifically limited to superficial wounds; rather, it plays a more comprehensive role in wound management for deeper tissue involvement as well. Hence, stating that total contact casting reduces edema through static compression accurately reflects its primary benefit in the context of wound care.