Total Contact Casting as the Gold Standard for Offloading Diabetic Foot Ulcers. Total contact casting has become the “gold standard” of off-weighting in lower extremity amputation prevention. Sibbald RG(1), Ayello EA. The "total contact cast" is a casting technique that is used to off-load and heal neuropathic foot ulcers. Numerous studies have demonstrated the excellent healing success of a TCC; however, its adoption in routine clinical use does not match its success rate. The total contact cast closely conforms to the exact shape of the foot – creating a chamber just right for healing. Lower extremity ischemia typically presents in the more severe end stages of peripheral arterial disease (PAD). What is a total contact cast (TCC)? Total Contact Casting (TCC): The Gold Standard of Care. What Medical Conditions Benefit from Total Contact Casting? The total contact cast (TCC) has long been considered the criterion (gold) standard of nonremovable plantar pressure redistribution devices for patients with diabetic foot ulcers (DFUs) because it relieves excessive pressure that delays wound healing. For more than 30 years, the “Gold Standard” approach for offloading DFUs has been the Total Contact Cast (TCC). TCC is regarded as the gold standard for offloading DFUs ; however, according to Wu et al. Total Contact Cast for Diabetic Foot Ulcers: An Underused "Gold Standard". The cast is Total contact casting (Scopus 39, Medline 40) Total contact cast (Scopus 63, Medline 30) Papers were rejected that were: General diabetic foot ulcer reviews, Charcot related, orthopaedic specific, foreign language or unavailable; this resulted in 32 papers combined from Scopus and Medline and the key papers are discussed. October 06, 2016. An extraordinary new review offers a treasure trove of information on offloading for diabetic foot ulcers (DFUs) and found that the total contact cast (TCC) is still the most effective offloading device. MRI showed osteomyelitis. A total contact cast (TCC) is considered the gold standard for healing diabetic foot ulcers (DFU). Following the Evidence for Total Contact Casting as First-Line Treatment of DFUs in the Wound Clinic. 1 The review focused on 13 randomized controlled trials. ... making it the “gold standard” for offloading. Total Contact Casting Provides Predictive Patient Outcomes. Total contact casting is the recognized Gold Standard of Care for off-loading diabetic foot ulcers M-Med provides the most versatile total contact cast on the market with the TCC-Mobility Series. The total contact cast is the gold standard of treatment and the standard of care for diabetic foot ulcers that are neuropathic, Wollheim said. **This video contains a graphic image of a diabetic foot ulcer. By Laurie Swezey RN, BSN, CWOCN, CWS, FACCWS Total contact casting (TCC) is considered to be the 'gold standard' in the treatment of diabetic foot ulcers. The gold standard for offloading is the total contact cast (TCC); yet, TCC use is contraindicated in patients with ischemia. TCC is the recognised gold standard treatment for diabetic foot ulceration and Charcot foot. This is for good reason. Many podiatrists consider total contact casting to be the ‘gold standard’ for effective ulcer wound care. Offloading was achieved through the application of ¼ inch adhesive-backed felt to the plantar surface of the foot and through the use of a diabetic walker boot and a wheelchair. Abstract: A total contact cast (TCC) is considered the gold standard for healing diabetic foot ulcers (DFU). 24,25 Rarely do patients with diabetic foot ulcers with similar presentation have to be casted more than 3 months before they are healed. The "total contact cast" is a casting technique that is used to off-load and heal neuropathic foot ulcers. agreed with Here’s a closer look at why this is the “gold standard” for treating this condition. Numerous studies have demonstrated the excellent healing success of a TCC; however, its adoption in routine clinical use does not match its success rate. This lack of … Total Contact Casting - Gold Standard in Off-Loading (Feb 27 from 5:30-7:30 pm) Mayo Course Directors: Karen Andrews, M.D., Tina Wangen, APRN, CNS, M.S., Jennifer Wolforth, R.N. Total contact casting has become the “gold standard” of off-weighting in lower extremity amputation prevention. TCCs have been listed by numerous sources as the gold standard for the treatment of diabetic neuropathic foot ulcerations and the beneficial effects of total contact cast have been documented in multiple prospective 19,27,32 and retrospective studies. In the treatment of diabetic foot ulcers, pressure modulation, commonly referred to as “offloading,” is most successful when pressure is mitigated at an area of high vertical or shear stress ( 1 ). Research has shown that the “total contact cast” is a casting technique that is used to heal diabetic foot ulcers shows healing rates of about 90% in 6 weeks (1-7). Total contact casting (TCC) is considered to be the ‘gold standard’ in the treatment of diabetic foot ulcers. Total Contact Casting the Charcot Foot By Eric Jaakola, DPM anD ryan Moss, DPM Continued on page 104 THE DIABETIC FooT Figure 1: Brodsky Classification The DFU Dilemma: Is the Total Contact Cast a True “Gold Standard”? Total contact casting (TCC) has long been referred to as the “gold standard” for treating non-infected, neuropathic foot ulcerations. This hands-on session will provide training in the application of these casts.