Custom Total Contact Cast System Used to Offload Foot Ulcers with Biomechanical Deformities
A recent case report published in Wound Management & Prevention highlights the effective use of a custom total contact cast system for managing plantar foot ulcers in patients with complex biomechanical deformities. The article details a patient with a history of Charcot neuroarthropathy and recurrent ulcerations who achieved successful wound healing through an individualized TCC approach.
Standard total contact casting may not always provide optimal pressure redistribution for patients with abnormal foot architecture. In this case, clinicians developed a custom TCC system that addressed the patient's instability and high-risk pressure points. By modifying the base of the cast and integrating supplemental support features, the treatment team was able to maintain mobility while ensuring effective offloading.
Key Takeaways
- Customized Systems: A flexible TCC approach is crucial for patients with structural foot deformities or prior surgical interventions.
- Offloading Efficiency: Even in complex cases, total contact cast systems can provide effective pressure redistribution and promote ulcer healing.
- Multidisciplinary Management: Close collaboration between wound care providers, orthotists, and physical therapists enhances TCC outcomes.
This case reinforces the clinical value of total contact cast systems as a gold-standard offloading method, even in the presence of anatomical challenges. Individualized adjustments can extend the benefits of TCC to a broader range of patients with diabetic foot ulcers.