Conclusion and References


 Diabetic foot ulcers present a challenge to even the most experienced practitioner. Important considerations include the choice of offloading, patient-centered concerns and local wound care. An interprofessional approach is best that includes medicine, foot specialists (chiropody/podiatry), nursing and other specialties to ensure all aspects of care are addressed adopting a patient-centric approach.

Key Takeaways

  • Pressure relief/offloading is essential for prevention and management of diabetic foot ulcers
  • Total contact non-removable cast walker is the preferred treatment choice based on individualized assessment
  • Consider knee-high offloading devices or alternative offloading device for heel pressure reduction
  • Offloading device selection may be influenced by: the presence of ischemia and/or infection, balance, physical abilities and other factors
  • Patient education and monitoring offloading of the diabetic foot ulcer should be included in each healthcare visit


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