The incidence of limb amputation due to ulcers is six per 1,000. Diabetes can cause dry skin, nerve damage and poor blood circulation to the extremities, predisposing patients to foot ulcers. The casts are made of soft cotton wrapping underneath a layer of fiberglass stripping and are specifically formed to each patient's foot, this relieving pressure from the ulcers and allowing them to heal. For a diabetic, a simple scratch or bruise on the foot can lead to an ulcer, and once formed, they are difficult to heal. Since diabetics often have no feeling or pain in their feet, they may not realize the implications of walking on an ulcer.
Patients generally wear the total contact casts for several weeks, giving the ulcer time to heal.
Then, they are fitted for special orthotic shoes, which they wear permanently to prevent other ulcers from forming.