Use of Pressure Offloading Devices in Diabetic Foot Ulcers: Do We Practice What We Preach?
- Stephanie C. Wu, DPM, MSc (Stephanie.wu{at}rosalindfranklin.edu)2,
- Jeffrey L. Jensen, DPM1,3,
- Anna K. Weber, DPM3,4,
- Daniel E. Robinson, DPM3 and
- David G. Armstrong, DPM, PhD2,5
- 1MedEfficiency, Denver, Colorado, USA
- 2 Scholl's Center for Lower Extremity Ambulatory Research (CLEAR) at Rosalind Franklin University of Medicine and Science, North Chicago, Illinois
- 3North Colorado Podiatric Surgical Residency Program, Denver, Colorado
- 4Private Practice Chicago, Illinois
- 5Department of Surgery/Southern Arizona Limb Salvage Alliance (SALSA), University of Arizona, Tucson, Arizona, USA
- 6Department of Surgery, Southern Arizona VA Health Care System, Tucson, Arizona, USA
Abstract
Purpose: Pressure mitigation is crucial for the healing of plantar diabetic foot ulcers (DFU). Characteristics and considerations associated with the use of offloading devices are discussed.
Methods: A DFU 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 DFU in each center.
Results: Of the 895 respondents that treat DFU, shoe modifications (41.2%, p<0.03) were the most common form of pressure mitigation while total contact casts (TCC) were used by only 1.7% of the centers.
Conclusions: This study reports the usage and characteristics of offloading devices in the care of DFU in a broadly distributed geographic sample. Less than 2% of specialists use what has been termed the "gold standard" (TCC) for treating the majority of DFU.
Footnotes
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- Received April 28, 2008.
- Accepted August 1, 2008.
- Copyright © American Diabetes Association
