{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,23]],"date-time":"2025-09-23T00:14:46Z","timestamp":1758586486614,"version":"3.44.0"},"reference-count":20,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,9,22]],"date-time":"2025-09-22T00:00:00Z","timestamp":1758499200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Endocrinol."],"abstract":"Background<\/jats:title>The basic principles of TCC are to achieve complete contact of the cast with the entire plantar surface of the foot and distribute the pressure at the sole. This method also reduces the shear forces generated at the wound edges and increases the healing potential of the wound.<\/jats:p><\/jats:sec>Purpose<\/jats:title>This study aimed to evaluate the effectiveness of a reusable fiberglass and polyester combined total contact cast (TCC) system in the treatment of plantar diabetic foot ulcers.<\/jats:p><\/jats:sec>Study Design<\/jats:title>A retrospective review was conducted on 70 patients treated with the reusable TCC system between January 2020 and September 2022.<\/jats:p><\/jats:sec>Methods<\/jats:title>The hospital\u2019s electronic medical record system was searched for cases using CPT code 29445 (application of a rigid total contact cast, half leg, adult). Patients included had persistent plantar ulcers at pressure points unresponsive to standard care and were treated with the TCC system until granulation tissue developed. Cases involving deep tissue infections or osteomyelitis were managed according to international diabetic foot guidelines.<\/jats:p><\/jats:sec>Results<\/jats:title>Out of 70 patients, 53 (75.7%) achieved complete wound closure. Seventeen patients showed no healing; among these, 9 underwent minor amputations and 1 required a major amputation. No significant difference in healing time was found based on ulcer location (forefoot, midfoot, hindfoot) (p=0.503).<\/jats:p><\/jats:sec>Conclusion<\/jats:title>The reusable fiberglass and polyester TCC system is a practical and cost-effective option for diabetic foot ulcers, offering outcomes similar to traditional TCCs. Continued use is recommended, with future research focusing on improving patient adherence and optimizing comfort in hybrid designs.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fendo.2025.1674774","type":"journal-article","created":{"date-parts":[[2025,9,22]],"date-time":"2025-09-22T04:12:48Z","timestamp":1758514368000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Reusable fiberglass and polyester combined total contact cast system for treatment of plantar diabetic foot ulcers: efficacy and cost-effectiveness"],"prefix":"10.3389","volume":"16","author":[{"given":"Alper","family":"Erkin","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hande Cengiz","family":"A\u00e7\u0131l","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ay\u015fe \u00c7elik","family":"Y\u0131lmaz","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Taner","family":"Demirci","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thomas","family":"Eberle\u0131n","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2025,9,22]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1177\/1071100717716486","article-title":"Outcomes achieved with use of a prefabricated roll-on total contact cast","volume":"38","author":"Arnold","year":"2017","journal-title":"Foot Ankle Int"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.12968\/jowc.2021.30.10.786","article-title":"Diabetic foot ulcers: treatment overview and cost considerations","volume":"30","author":"Moore","year":"2021","journal-title":"J Wound 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Data from the US Wound Registry","volume":"27","author":"Fife","year":"2014","journal-title":"Adv Skin Wound Care"},{"key":"B15","doi-asserted-by":"publisher","DOI":"10.1177\/1534734620942671","article-title":"The real-life outcome of VACOped boot in the management of diabetic foot ulcers","volume":"21","author":"Lim","year":"2020","journal-title":"Int J Lower Extremity Wounds"},{"key":"B16","doi-asserted-by":"publisher","DOI":"10.4103\/jodp.jodp_14_22","article-title":"Total contact casting: A forgotten art in the management of neuropathic foot ulcers","volume":"5","author":"Chemboli","year":"2022","journal-title":"J Orthop Dis Traumatol"},{"key":"B17","article-title":"The effect of alternative offloading techniques on the area of diabetic foot ulcus towards the duration of the wound healing process","volume":"3","author":"Monika","year":"2021","journal-title":"Int J Soc Sci World"},{"key":"B18","doi-asserted-by":"publisher","DOI":"10.1016\/j.diabres.2022.110036","article-title":"Comparing a non-removable total contact cast with a non-removable softcast in diabetic foot ulcers: A retrospective study of a prospective database","volume":"191","author":"Vierhout","year":"2022","journal-title":"Diabetes Res Clin Pract"},{"key":"B19","doi-asserted-by":"publisher","DOI":"10.1002\/jfa2.70001","article-title":"A mouldable fibreglass backslab device as a novel approach to offload chronic plantar foot ulcers: A retrospective observational audit","volume":"17","author":"Ting","year":"2024","journal-title":"J Foot Ankle Res"},{"key":"B20","doi-asserted-by":"publisher","first-page":"S4","DOI":"10.12968\/jowc.2014.23.Sup7.S4","article-title":"A comparison of two total contact cast constructs with variable body mass","volume":"23","author":"Pirozzi","year":"2014","journal-title":"J Wound Care"}],"container-title":["Frontiers in Endocrinology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fendo.2025.1674774\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,22]],"date-time":"2025-09-22T04:12:49Z","timestamp":1758514369000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fendo.2025.1674774\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,9,22]]},"references-count":20,"alternative-id":["10.3389\/fendo.2025.1674774"],"URL":"https:\/\/doi.org\/10.3389\/fendo.2025.1674774","relation":{},"ISSN":["1664-2392"],"issn-type":[{"value":"1664-2392","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,9,22]]},"article-number":"1674774"}}