de Oliveira AL, Moore Z, et al.
Journal of wound care. Date of publication 2015 Dec 1;volume 24(12):560, 562-70.
1. J Wound Care. 2015 Dec;24(12):560, 562-70. doi: 10.12968/jowc.2015.24.12.560.
Treatment of the diabetic foot by offloading: a systematic review.
de Oliveira AL(1), Moore Z(2).
Author information:
(1)Staff Nurse, Professor and Head of the School of Nursing and Midwifery The
Royal College of Surgeons in Ireland.
(2)Professor and Head of the School of Nursing and Midwifery, The Royal College
of Surgeons in Ireland.
OBJECTIVE: To compare the literature on the strengths and limitations of
different offloading devices in the treatment of diabetic foot ulcers.
METHOD: Systematic review of the literature in the following databases: the
Cumulative Index to Nursing an Allied Health Literature (CINAHL); Medline;
Embase; Cochrane Library and Web of Knowledge. The search strategy used the
terms: diabetic foot; orthosis/orthotic devices/orthoses; foot orthosis/foot
orthoses; casts/plaster cast/surgical cast; shoes.
RESULTS: Our results identified 15 studies, which are included in this review.
Healing rates, healing times and reduction in ulcer size were improved with the
use of total contact casting, when compared with other offloading devices. The
main adverse effects associated with the use of the device were infection,
maceration and abrasion. Cost, compliance and quality of life issues were rarely
included within the studies.
CONCLUSION: Offloading is a key treatment strategy for the management of diabetic
foot ulcers and total contact casts were found to be the most effective devices
to achieve ulcer healing. However, they are not without complications and their
impact on cost, compliance and quality of life is not well understood.
DOI: 10.12968/jowc.2015.24.12.560
PMID: 26654736 [Indexed for MEDLINE]
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