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Treatment of Diabetic Foot Ulcers
Off-Loading
Relieving the mechanical pressure on diabetic foot ulcers, known as "off-loading", is an integral aspect in the management of patients with diabetic foot ulcers. A variety of off-loading strategies are available that include:
- Casts (e.g., total contact casts or boot casts)
- Assistive ambulatory devices (e.g., crutches; wheelchairs)
- Braces (e.g., fixed-ankle walking brace)
- Special shoes (e.g., modified half-shoes; sandals; "postoperative" shoes with cushioned inserts)
- Felted foam, soft polymeric insoles, and special orthoses can also be used in ambulatory devices to provide pressure relief
Irrespective of the off-loading strategy used to provide mechanical pressure relief, patients with diabetic foot ulcers should be urged to replace poorly-fitting shoes that predispose to recurrence of diabetic foot ulcers. Rest and elevation of the affected foot are also important for promoting healing of diabetic foot ulcers.
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