The "Carville" sandal is a device which can serve a variety of purposes. The sandal is made with several densities of a polyethylene foam called plastizote. The sandal footbed is molded directly from the patient's foot. A sock is worn for the molding process although the temperature of the materials should not be hot enough to cause burns.
The sandal upper can be made from one of several materials. The standard strapping is made of cotton webbing. This material allows for use in the shower.
Other materials include betapile used for patients with fragile skin and leather can also be used to extend the life of the sandal. The straps are held together with Velcro.
The sandal soling can be left flexible or made rigid depending upon the severity of foot deformity. For a semi-rigid sandal, firm black plastizote is added around the soling; and for a rigid rocker sole, metal staves can be incorporated into the layers.
The sandal is an ideal interim device for use after a plantar wound has healed. Our protocol for wound healing includes a slow return to footwear after wound closure in a cast or splint. If not initially fabricated for wound healing, a splint is fabricated after wound closure and is used as a protective device which can be removed to allow for slow, progressive ambulation in the sandal or footwear. All patients with a loss of protective plantar sensation and a recently healed plantar ulcerations are instructed to use their custom made sandals for progressive in-house ambulation and for use in the shower or bath. We advise patients to consider a shower chair for safety.
The sandal can also be used in some circumstances as a healing device and is particularly good for relief of toe lesions. Simply carving out a well in the plastizote with a hand held grinder or knife provides excellent pressure relief.
The sandal is very easy to don and very comfortable for patients. Patients are advised to limit the use of sandals to their household once permanent footwear has been provided. The sandals provide excellent protection, but cannot withstand the rigors of constant outdoor use and unlevel terrain.