Application of total contact cast in diabetic foot syndrome: results of a clinical study
https://doi.org/10.51922/2074-5044.2026.2.4
Abstract
Aim. To evaluate the clinical effectiveness and economic feasibility of using modified immobilizing offloading bandages of the Total Contact Cast (TCC) type in patients with diabetic foot syndrome.
Materials and Methods. A total of 119 patients with neuropathic foot ulcers were analyzed. The study was conducted in two stages: a retrospective analysis of 34 patients treated with standard TCC, and a prospective study of 85 patients treated with a modified TCC design. The modification consisted of a rigid support inserted between layers of synthetic plaster, improving stability, durability, and walking comfort. All casts were removable, allowing patients to perform wound dressing independently. Effectiveness was assessed by ulcer healing and duration of cast use. Statistical analysis included descriptive statistics, Mann–Whitney U test, Fisher’s exact test, and Z-test for proportions.
Results. Positive outcomes were achieved in 72.9 % of patients in the modified TCC group compared to 47.1 % in the standard TCC group (OR = 3.033; 95 % CI: 1.327–6.928; p = 0.0103). The absolute difference in healing rates was +25.8 %, confirmed by Z-test (p = 0.014). Economic evaluation demonstrated reduced material costs and shorter periods of disability in the modified TCC group.
Conclusion. Modified removable TCC provides significantly higher healing rates of neuropathic foot ulcers compared to standard TCC, while improving patient comfort and reducing complications. The method is clinically effective and economically feasible for outpatient practice. Further multicenter studies are recommended to assess long-term outcomes and patient quality of life.
About the Authors
Н. A. Bliznets
Institute of Advanced Training and Retraining of Healthcare Personnel of the educational institution «Belarusian State Medical University»; Minsk City Clinical Endocrinology Center
Belarus
Belarus
Minsk
I. A. Hadji Ismail
Institute of Advanced Training and Retraining of Healthcare Personnel of the educational institution «Belarusian State Medical University»
Belarus
Belarus
Minsk
I. S. Рukita
Minsk City Clinical Endocrinology Center
Belarus
Belarus
Minsk
M. О. Vasilyeu
Minsk Regional Clinical Hospital for Disabled Veterans of the Great Patriotic War named after P.M. Masherov
Belarus
Belarus
Minsk
V. M. Shyshko
Minsk City Clinical Endocrinology Center
Belarus
Belarus
Minsk
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Review
For citations:
Bliznets Н.A., Hadji Ismail I.A., Рukita I.S., Vasilyeu M.О., Shyshko V.M. Application of total contact cast in diabetic foot syndrome: results of a clinical study. Military Medicine. 2026;(2):4-10. (In Russ.) https://doi.org/10.51922/2074-5044.2026.2.4
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