T is for Total Contact Cast

November 7, 2012

A total contact cast is probably the gold standard by which treatments for healing plantar diabetic foot ulcers are measured against.

A total contact cast (TCC) is a specialized type of cast used in the treatment of certain foot and ankle conditions. It is designed to distribute weight-bearing forces evenly across the entire surface of the foot, providing effective offloading and pressure redistribution.

The primary purpose of a total contact cast is to facilitate the healing of foot ulcers, particularly in individuals with diabetic foot ulcers or other non-healing wounds. The cast is applied by a healthcare professional, typically a podiatrist or wound care specialist, and involves several layers of padding and casting material.

Key features and benefits of a total contact cast:

  1. Even weight distribution: The TCC is specifically designed to offload pressure from the affected area, such as a foot ulcer or a specific pressure point. By distributing weight evenly across the entire foot, the cast helps reduce pressure on the ulcer or wound, promoting healing.
  2. Immobilization and protection: The total contact cast immobilizes the foot and ankle, providing stability and protection to the affected area. This immobilization helps prevent further trauma, reduces movement-related pain, and supports the healing process.
  3. Offloading and pressure redistribution: The cast effectively redistributes pressure away from the ulcer or wound onto the surrounding healthy tissues. This helps alleviate pressure and shear forces on the area, which are known to impede wound healing.
  4. Moisture control: The cast material has properties that help control moisture and maintain an optimal healing environment for the wound. It can absorb excess moisture and allow for evaporation, reducing the risk of bacterial growth and infection.
  5. Compliance and patient education: The total contact cast requires specialized application and proper care. This necessitates regular visits to healthcare professionals, ensuring that patients receive proper education on cast care, weight-bearing instructions, and monitoring of the healing progress.

Total contact casting is highly effective for offloading foot ulcers, it may not be suitable for all individuals or conditions. Factors such as the location and severity of the ulcer, the presence of infections, and the overall health status of the individual need to be considered before applying a total contact cast.


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