A method and device are shown for use in casting for Total Contact Casting for offloading pressure in neuropathic and diabetic wounds or fractures of the appendages such as the human leg or foot. The outer casting material used can be comprised of traditional casting materials. A total foot protection pad underlies the traditional casting materials. It is a one piece moldable system that encompasses the total foot from the Achilles along the lateral and medial foot, covering the plantar surface, the malleoli and folds and extends over the dorsum. The one piece system has adhesive backing on a contact side to facilitate its application and/or forms a total foot protection pad beneath the outer hardened casting material.
