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A distinguishing factor of high-quality off-loading devices like the CIMA 4U Top is the concept of Total Contact Casting (TCC) principles. The insole is often heat-moldable, allowing the clinician to create a precise mold of the patient's foot. When the foot rests in this mold, body weight is distributed evenly, "floating" the ulcerated area away from the source of pressure cima 4u top