Open foot wounds resulting from diabetic Charcot foot are very problematic to treat secondary to the anatomic abnormalities as well as the profound neuropathy associated with this condition. With these complexities in mind, most prospective trials, to some degree, exclude these patients from inclusion. Total contact casting and tissue-based therapy, including skin grafts, can be helpful in closing these wounds. However, rapid recurrence is very common. The authors present one technique to help alleviate the pressure point(s) and provide more adequate coverage for these problematic wounds.