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Use of Pressure Offloading Devices in Diabetic Foot Ulcers: Do We Practice What We Preach?

Overview
Journal Diabetes Care
Specialty Endocrinology
Date 2008 Aug 13
PMID 18694976
Citations 58
Authors
Stephanie C Wu
Jeffrey L Jensen
Anna K Weber
Daniel E Robinson
David G Armstrong
Affiliations
Soon will be listed here.
Abstract

Objective: Pressure mitigation is crucial for the healing of plantar diabetic foot ulcers. We therefore discuss characteristics and considerations associated with the use of offloading devices.

Research Design And Methods: A diabetic foot ulcer management survey was sent to foot clinics in all 50 states and the District of Columbia in 2005. A total of 901 geographically diverse centers responded. The survey recorded information regarding usage frequency and characteristics of assessment and treatment of diabetic foot ulcers in each center.

Results: Of the 895 respondents who treat diabetic foot ulcers, shoe modifications (41.2%, P < 0.03) were the most common form of pressure mitigation, whereas total contact casts were used by only 1.7% of the centers.

Conclusions: This study reports the usage and characteristics of offloading devices in the care of diabetic foot ulcers in a broadly distributed geographic sample. Less than 2% of specialists use what has been termed the "gold standard" (total contact cast) for treating the majority of diabetic foot ulcers.

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