Baker, Neil

Cundell, Jill

English

The term “offloading” is generally given to techniques employed in the treatment ofactive foot ulceration or immobilisation of acute Charcot neuroarthropathy. It canequally be used for modalities and strategies for the prevention of new and relapseulcers. In this context, perhaps the term “deleterious force management” wouldbe better suited. Preventing the first ulcer is the ultimate goal of risk screening andstratification thus understanding the mechanisms for ulceration should direct cliniciansto employ timely and appropriate offloading strategies. The rate of ulcer relapse is veryhigh with reported rates of 40% in 4–12 months and 70% in 3 years. Managing healedulcers is complex and requires considerable understanding and sustained activity.Central to all of this is active patient involvement and unhindered, easy access to footprotection teams, as well as adequate resource allocation. It is the authors’ view thatsadly perhaps more focus is placed upon ulcer healing rather than preventing relapse.This article will briefly explore the area of “offloading” in the prevention of ulcerationand its relapse. When reading this article, it would be useful to bear in mind some of the concepts that were previously discussed in the authors’ article in The Diabetic Foot Journal 19(4), ‘The principles and practicalities of offloading diabetic foot ulcers’

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Offloading in ulcer prevention and its relapse

https://pure.ulster.ac.uk/ws/files/71177966/Baker_and_Cundell_DFJ_2017.pdf

Offloading in ulcer prevention and its relapse

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