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Published on: March 3, 2023
Total Contact Casting for Diabetic Foot Ulcers in Partial-Foot Amputations
Garrett Ruff1, Uzaam Syed2, Louis Iannuzzi3
1NYU Grossman School of Medicine, New York, NY.
Advances in Skin & Wound Care
|May 19, 2026
Summary
Total contact casting (TCC) effectively heals diabetic stump ulcers in partial-foot amputees. However, smoking increases the risk of re-ulceration, highlighting the need for smoking cessation support in these patients.
Area of Science:
- Podiatry
- Diabetology
- Vascular Surgery
Background:
- Diabetic stump ulcerations in patients with partial-foot amputations present a significant clinical challenge.
- Effective management strategies are crucial to prevent further complications like re-amputation.
Purpose of the Study:
- To evaluate patient outcomes following total contact casting (TCC) for diabetic stump ulcerations.
- To identify predictors of outcomes and complications associated with TCC in this patient population.
Main Methods:
- Retrospective review of 43 patients treated with TCC for diabetic stump ulcerations and partial-foot amputation.
- Exclusion criteria included loss to follow-up, TCC intolerance, and specific digit amputations.
- Multivariable linear regression analyzed demographic predictors of ulcer closure time.
Main Results:
- High primary ulcer closure rate (93.5%) was observed.
- Significant rates of re-ulceration (46.5%) and re-amputation (9.3%) were noted.
- Nonsmoking status was associated with a lower likelihood of re-ulceration; smoking trended towards delayed closure.
Conclusions:
- Total contact casting is an effective treatment for diabetic stump ulcerations in patients with partial-foot amputations.
- Smoking history is a significant risk factor for increased re-ulceration rates.
- Patient outcomes are generally favorable, but smoking cessation should be emphasized.
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