Your diabetic patient has a superficial infection in a plantar foot ulcer without ischemia. Are they a candidate for Total Contact Casting (TCC)?

Total Contact Casting (TCC) is a highly effective treatment for diabetic foot ulcers, particularly those that are not complicated by ischemia. In the context of a superficial infection in a plantar foot ulcer without ischemia, the use of TCC is appropriate because the casting provides off-loading and protection to the ulcer, facilitating healing while allowing the patient to remain ambulatory.

TCC works by distributing weight across the entire surface of the cast, which helps to reduce pressure on the ulcer site, an important factor for healing. The key consideration here is the absence of ischemia. Ischemia, or insufficient blood flow, can hinder healing and pose risks when using TCC, as the cast can further impair circulation. However, since the patient does not have ischemia, TCC can be safely applied to protect the affected area and promote healing.

In summary, the presence of a superficial infection does not preclude the use of TCC, provided that there are no other complicating factors such as poor blood flow, making it a suitable choice for this patient.