A prospective multicenter study of the effects of total contact casting on non-healing foot ulcers in Japan

Abstract

Total contact casting（TCC）is an offloading modality used in the treatment of foot ulcers to reduce plantar pressure and the shear forces generated during walking. It can be performed in the outpatient setting. We conducted a multicenter prospective registry study to examine the effects, complications, and costs of using TCC as a treatment for refractory foot ulcers among maintenance dialysis patients and patients with diabetes and lower-extremity peripheral arterial disease. Among 55 patients（36 males and 19 females; mean age, 58.2±11.7 years）who were treated with TCC for foot ulcers that were refractory to 4 weeks of standard treatment, favorable outcomes were observed in 42（76.4%）, with 26（47.3%）, 33（60%）, 42 （74.5%）, and 43（76.4%）achieving a cure or sufficient improvement at 4, 8, 12, and 16 weeks, respectively. Only four（7.3%）patients discontinued treatment due to adverse events. These results show that TCC is a highly effective and safe treatment for refractory foot ulcers in Japan.