Abstrak:
Diabetic foot ulcers (DFUs) represent a significant complication of diabetes mellitus, frequently accompanied by impaired wound healing and an elevated susceptibility to infections. The management of DFUs, particularly in the presence of complex concurrent conditions such as calcaneus fractures, represents a significant clinical challenge. Total Contact Casting (TCC) is one of the most established offloading modalities, enhancing wound healing by redistributing pressure away from the ulcer site. This case report assesses the effectiveness of TCC in a patient with a diabetic foot ulcer complicated by a fracture of the right calcaneus (calcaneus fracture dextra). Method this study conducted was a 53-years-old male with diabetic foot ulcer. The wound assessment initialy fracture in calcaneous dextra wtih bone expose, heavy exudate, odor, macerated. TIMERS Management was applied in local woundcare and addtional was applied TCC as treatment modality over a periode 5 monts. Clinical assessment included wound characteristic (granulation tissue, exudate, maserated), Radiographic imaging. Result the application of TCC reduced the size of the wound significantly (by 95% reduction in wound area) and improved wound healing. NPWT was applied in Local Woundcare. The wound is still exuding a moderate amount of exudate, which is causing maceration of the surrounding tissue. The use of a stoma bag is recommended to prevent maceration and collect exudate. Radiographic follow-up showed progressive healing of the fracture of the calcaneus. There were no complications related to the application of TCC, such as skin maceration or secondary infections. Conclusion the utilisation of TCC for the management of diabetic foot ulcers in conjunction with calcaneal fractures has yielded encouraging outcomes with respect to wound healing and fracture stabilisation. TCC effectively relieves pressure, thereby facilitating wound healing and reducing patient discomfort.
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