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TCC-EZ® Product Application

TCC-EZ® is an easy to use system that offers the stability of a traditional total contact cast but requires less time commitment and is more comfortable for patients with a diabetic foot ulcer. TCC-EZ® offers a one-piece, roll-on, light weight, woven design that is faster and easier than the traditional total contact cast.18

TCC-EZ Application Video
TCC-EZ Removal Video
View TCC-EZ® Youtube Channel

Quick 1,2,3 Prep/Roll/Apply Process

Easy roll-on, one layer, lightweight structure, all-in-one kit

1 Prep (Patient Preparation)

  • Apply foam dressing
  • Apply stockinette to below knee, fold over, leaving space around toes, and tape
  • Apply felt padding and secure with tape
  • Roll protective sleeve into a donut, then onto leg, and trim felt padding to be even with sock
Total Contact Cast Patient Preparation

2 Roll (Casting)

  • Roll TCC-EZ® cast sock into loose donut and immerse in water 70°-80°F) for 5-10 seconds, squeeze gently under water and then shake out excess (do not wring out)
  • Unroll cast onto leg and hold foot at a 90° angle
  • Fold edges near knee and toe to finish
  • Aggressively rub the cast sock for 3-5 minutes to activate the resin and customizing the cast to the leg (keep foot at a 90° angle)
Total Contact Casting

3 Apply (Outer Boot)

  • After the cast sock has cooled and hardened apply the outer boot (15-20 minutes)
  • Apply outer boot, aligning struts with tibia and fibula
  • Patient’s activity must be limited for 24 hours following application
Apply Total Contact Casting

TCC-EZ® Removal Instruction

  • Remove outer boot
  • Identify padding
  • Using cast saw – cut on padding from tibia to toes
  • Using bandage scissors cut white sock to dorsum of foot
  • Pull padding toward toes
  • Remove foot from cast

*Do Not Bivalve Cast Remove!

Total Contact Casting Removal

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