Total Contact Cast System to Heal Diabetic Foot Ulcers

Off-loadinga diabetic foot ulcer is a cornerstone of quality wound care for diabetic patients to allow cellular growth in the wound bed. While total contact casts (TCC) have been described as the gold standard for off-loading the wound, the complexity of application and the time commitment for both application and drying have discouraged health professionals from using them. This retrospective case series, conducted in a podiatric practice, evaluated using a TCC system that helps address the three components in which guidelines should be addressed when caring for a diabetic foot: V - vascular management, I - infection management and prevention, and P - pressure relief. This studied TCC system can be applied in approximately seven minutes and the patient can ambulate immediately without waiting for drying. Of the 20 wounds treated with this TCC, 18/20 (90%) healed in a mean of 22.3 days. The mean number of TCC treatments was 2.8. When compared to evidence published in the scientific literature documenting healing outcomes using various TCCs, this system has the fastest observational healing rate. In this case series, this TCC system for off-loading was found to be clinically beneficial for the patient in a physician's office practice.