Derma Sciences Regions Map

Select your location from over 190 countries where Derma Sciences operates.

TCC-EZ® Patient Information

Discuss with your doctor if Total Contact Casting is right for you!

Find out more information at

How serious is my foot ulcer?

Unfortunately, if left untreated, diabetic foot wounds can become serious, placing you at risk for amputation and other life-threatening conditions. Early and effective management of the wound is the safest route to preventing complications. With Total Contact Casting (TCC), your doctor has selected a proven method which has been shown in clinical trials to heal 9 out of 10 foot wounds in about 6 weeks1, 2.

What You Need To Know About Your Total Contact Cast

Managing a wound with a TCC can help it to heal faster and more comfortably when used along with a plan of care that is individualized for you by your health care provider. Many studies have shown that 89% of wounds heal in about 6 weeks with TCC1,2.

What is Total Contact Cast?

A Total Contact Cast is a cast used to help promote healing by minimizing pressure and friction at the wound site, typically for diabetic foot wounds.

How does it help?

A TCC is in “total contact” with the foot and lower leg to redistribute weight away from the wound. It allows for healing even while walking.

Who is it for?

Typically it is used for patients being treated for diabetic foot ulcers, Charcot neuroarthropathy, and post-operative surgical site protection.


The TCC-EZ® Total Contact Cast System should be recommended and supervised by a physician or licensed healthcare provider. If the vascular status is not adequate for healing or the wound is infected or involves deeper structures (tendon, joint capsule, or exposed bone) do not apply the TCC-EZ®. Infection must be ruled out before treating patients with the TCC-EZ®. Inappropriate use of the total contact cast could result in serious injury to the patient and/or potential loss of limb. Improper removal of the total contact cast may also result in injury to the patient.

The TCC-EZ® should be removed and the patient reassessed prior to reapplication in all of the following circumstances:

  • If the cast is “loose” or “rubbing” or “pistoning”
  • If the cast is causing pain
  • If the patient develops fever, chills, nausea, or vomiting
  • If the cast gets wet
  • If the patient or healthcare provider has other cause for concern, such as claustrophobia

1. Armstrong DG, et al. Off-loading the diabetic foot wound. Diabetes Care 24:1019-1022, 2001 2. Bloomgarden ZT: American Diabetes Association 60th Scientific Sessions, 2000. Diabetes Care 24:946-951, 2001. 3. Coleman W, Brand PW, Birke JA: The total contact cast, a therapy for plantar ulceration on insensitive feet. J Am Podiatr Med Assoc 74:548 –552, 1984. 4. Helm PA, Walker SC, Pulliam G: Total contact casting in diabetic patients with neuropathic foot ulcerations. Arch Phys Med Rehabil 65:691– 693, 1984. 5. Baker RE: Total contact casting. J Am Podiatr Med Assoc 85:172–176, 1995 6. Sinacore DR, Mueller MJ, Diamond JE: Diabetic plantar ulcers treated by total contact casting. Phys Ther 67:1543–1547,1987 7. Myerson M, Papa J, Eaton K, Wilson K: The total contact cast for management of neuropathic plantar ulceration of the foot. J Bone Joint Surg 74A:261–269, 1992 8. Walker SC, Helm PA, Pulliam G: Chronic diabetic neuropathic foot ulcerations and total contact casting: healing effectiveness and outcome probability (Abstract). Arch Phys Med Rehabil 66:574, 1985 9. Mueller MJ, Diamond JE, Sinacore DR, Delitto A, Blair VPD, Drury DA, Rose SJ: Total contact casting in treatment of diabetic plantar ulcers: controlled clinical trial. Diabetes Care 12:384 –388, 1989 10. Liang PW, Cogley DI, Klenerman L: Neuropathic ulcers treated by total contact casts. J Bone Joint Surg 74B:133–136, 1991 11. Walker SC, Helm PA, Pulliam G: Total contact casting and chronic diabetic neuropathic foot ulcerations: healing rates by wound location. Arch Phys Med Rehabil 68:217–221, 1987 12. Armstrong DG, Lavery LA, Bushman TR: Peak foot pressures influence the healing time of diabetic foot ulcers treated with total contact casts. J Rehabil Res Dev 35: 1–5, 1998 13. Lavery LA, Vela SA, Lavery DC, Quebedeaux TL: Reducing dynamic foot pressures in high-risk diabetic subjects with foot ulcerations: a comparison of treatments. Diabetes Care 19:818–821, 1996 14. Lavery LA, Armstrong DG, Walker SC: Healing rates of diabetic foot ulcers associated with midfoot fracture due to Charcot’s arthropathy. Diabet Med 14:46–49, 1997 15. Lavery LA, Vela SA, Lavery DC, Quebedeaux TL: Total contact casts: pressure reduction at ulcer sites and the effect on the contralateral foot. Arch Phys Med Rehabil 78:1268–1271, 1997. 16. Fife CE; Carter MJ, Walker D: Why is it so hard to do the right thing in wound care? Wound Rep Reg 18: 154–158, 2010. 17. Jensen J, Jaakola E, Gillin B, et al: TCC-EZ –Total Contact Casting System Overcoming the Barriers to Utilizing a Proven Gold Standard Treatment. DF Con. 2008. 18. Snyder RJ, et al. The Management of Diabetic Foot Ulcers through Optimal Off-loading. Building Consensus Guidelines and Practical Recommendations to Improve Outcomes. Journal of the American Podiatric Medical Association. Vol 104. No. 6. Nov/Dec 2014. 19. Lavery AL, et al. Randomised clinical trial to compare total contact casts, healing sandals and a shear-reducing removable boot to heal diabetic foot ulcers. Int Wound J 2014. 20. Fife CE, et al. Diabetic foot ulcer off-loading: The gap between evidence and practice. Data from the US Wound Registry. Adv Skin Wound Care. 2014 Jul;27(7):310-6. 21. Piagessi, et al., Semiquantitative Analysis of the Histopathological Features of the Neuropathic Foot Ulcer, Diabetes Care. 2003 Nov;26(11):3123-8. 22. Bohn G. Cost, Effectiveness and Implementation of an Easy to Apply Total Contact Casting System for Diabetic Grade 2 Neuropathic Foot Ulcers in a Multi Physician Clinic, Clinical Symposium on Advances in Skin and Wound Care, October 2009, San Antonio, USA, Poster. 23. Snyder RJ, et al. The Management of Diabetic Foot Ulcers through Optimal Off-loading. Building Consensus Guidelines and Practical Recommendations to Improve Outcomes. Journal of the American Podiatric Medical Association. Vol 104. No. 6. Nov/Dec 2014