Total Contact Cast (TCC) for Diabetic Foot Ulcer

A diabetic foot ulcer on the sole of the foot (often called "diabetic foot ka ghaav") will not heal if the patient keeps walking on it. A Total Contact Cast (TCC) solves this by taking pressure off the wound while the patient stays mobile. In this short video, Elegance Diabetic Foot & Ulcer Clinic (EDFC), Surat shows how a TCC is used for diabetic foot ulcer care, under the guidance of Dr. Ashutosh Shah.

What Is a Total Contact Cast?

A Total Contact Cast is a specially applied cast that fits closely around the whole foot and lower leg. Because it touches every part of the sole, it spreads body weight evenly and removes pressure from the ulcer. It is widely regarded as one of the most effective ways to offload a diabetic foot ulcer.

Who May Benefit From TCC

• Ulcers on the sole of the foot caused by pressure and nerve damage
• Ulcers that have not healed with dressings and footwear alone
• Patients with active Charcot foot, to protect the foot while it settles

TCC is usually not used when there is active infection or severely reduced blood flow. The foot is assessed first to make sure it is safe.

What to Expect

• The ulcer is cleaned and dressed before the cast is applied.
• The cast is usually changed every week or as advised, so the wound can be checked and re-dressed.
• Patients can walk in the cast, but are advised to limit standing and walking.
• Once the ulcer heals, protective footwear helps stop it from coming back.

Learn more about footwear and offloading, neuropathic ulcers and Charcot foot.