Total contact casts are recognized as the gold standard treatment for neuropathic plantar diabetic foot ulceration, endorsed by all national and international consensus papers. Despite this, research has shown that there is a dichotomy between the existing evidence which supports the use of total contact casts in the management of diabetic foot ulcers and its use in clinical practice. This article aims to highlight the benefits, risks, and barriers associated with total contact cast use in the management of diabetic foot ulcers in the clinical setting, with an emphasis on existing research carried out in this field to encourage change in clinical practice and utilization of this effective treatment modality.
Keywords: Clinical practice; DFU, Diabetic foot ulcer; DPN, Diabetic peripheral neuropathy; Diabetic foot ulcer; Evidence-based medicine; PAD, Peripheral arterial disease; Risks and benefits; Total contact cast.