Diabetic foot care

Reduction of pressure in diabetic foot care, known as offloading, is an essential aspect of neuropathic foot (diabetic) wound care. Foot pressures, shock and shear can be reduced with appropriately fitted shoes, insoles, and socks.

The most effective method of relieving pressure in diabetic foot care is total non-weight bearing approaches such as using a wheelchair or crutches. However, most patients have difficulty complying with these modalities.

According to published studies and when appropriately applied, total contact casts (TCCs) and prefabricated casts heal greater than 72 percent of patients by significantly reducing pressure. TCCs are used for offloading the plantar aspect of the foot.

However, total contact casts for diabetic foot care may cause additional problems, such as joint stiffness, muscle atrophy, the possibility of new ulcerations and skin breakdown, labor-intensive application, and possible laceration of the patient during cast removal. Contact dermatitis and fungal infection also may occur.

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