This study compared the outcome of total contact casting (TCC) with traditional

dressing treatment (TD) in the management of neuropathic diabetic plantar ulcers.

Thirty one patients with plantar ulcers without any gross infection, osteomyelitis or

gangrene were randomly assigned to the TCC group (n = 15) or TD group (n = 16). In

the experimental group, TCC was applied on the initial visit and subjects were

Instructed weekly follow up and to limit ambulation to one–third of their usual

activity. Subjects in the control group (TD) were prescribed dressing changes and

were advised against bearing weight on the involved extremity. Ulcers were

considered healed if they showed complete skin closure with no drainage. Non

healed ulcers were those which showed no decrease in size by 6 weeks or if infection

developed requiring hospitalization. In the TCC group, 12 out of 15 ulcers healed in

48±7 days; in the TD group, 10 out of 16 ulcers healed in 58±9 days. Comparatively

higher rate of ulcer healing with fewer infections was seen in the TCC group. New

abrasions were a frequent complication of TCC which can be reduced with frequent

cast changes.We conclude TCC is a more effective method than dressing for treating

diabetic plantar ulcers reducing the risks of amputation.