• Pressure is a factor in 90% of diabetic plantar ulcers and the pressure must be modified or removed in order to heal the ulcers and prevent recurrence.
• Diabetic foot ulcer (DFU) recurrence is significantly reduced with professionally fitted footwear and insoles/orthoses.
• Three main factors contribute to elevated foot pressures that result in ulceration:
1. Intrinsic: neuropathy, altered blood flow, genetic or structural deformity
2. Extrinsic: shoes, ambulation and weight-bearing activity, traumatic accident or surgery
3. Behavioural: poor choice of footwear, lifestyle choices, type of ambulatory activity
• Offloading is the key to managing patients with a DFU and preventing further ulceration for the rest of the patient’s life. Clinicians should always remember that considerations when offloading the foot are not limited to the device itself, but also include patient characteristics, environmental factors, appropriate use of the device, modification of activity, reduction of walking speed and alteration of gait.
Link to Wounds Canada Product Picker Article
Sarah Lockbaum RPN, CDE, IIWCC
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