While total-contact casts (TCCs) remain, along with other irremovable devices the gold standard for off-loading diabetic foot ulcers in people who can tolerate them, concerns about immobility and venous thrombosis have lingered.
Our recent systematic review found surprisingly low rates of deep venous thrombosis (DVT) in patients treated with TCCs—only 1 in 136 cases (~0.7%), compared with rates up to 40% in general lower-limb immobilization.
These findings reinforce what clinicians have long observed: frequent recasting and partial mobility may protect against thrombosis, even while promoting ulcer healing.
Citation:
Tsai R, Bazikian S, Shin L, Woelfel S, Armstrong DG.
“Prevalence of Deep Venous Thrombosis in the Treatment of Diabetic Foot Ulcers with Total-Contact Casts.”
J Am Podiatr Med Assoc. 2025;115(5). doi:10.7547/23-195
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