Continued offloading after wound healing can break the cycle of recurrent diabetic foot ulceration (DFU), according to a recent case study. The patient who was treated with the method had a two-year history of recurrent DFU to the right fourth metatarsal head following amputation of the fourth digit. Recurrence continued despite self-reported compliance with therapeutic footwear use. The researcher’s novel offloading modality incorporated intermittent pneumatic compression, smart technology for monitoring patient compliance with use, and the ability to continue therapeutic shoe gear use upon wound resolution. Wound resolution was achieved at five months, and the patient remained free of DFU recurrence for more than three years with continued use of the device’s shoe gear.
The author noted that traditional offloading methods end with wound resolution, after which patients are transitioned back to normal or therapeutic footwear, but an offloading modality (PulseFlow DF) rather than a removable walking boot, an offloading component that transferred weight from the foot to the lower leg and a shoe (FootForte), and an insert (Aresta) with D30 impact technology was chosen instead. The offloading component included a bladder at the arch of the foot that provided intermittent compression in a 20-second cycle (1 second of inflation followed by a 19-second deflation). A sensor located in the shin section of the offloading component recorded the number of hours the device was worn and had an audible alarm if the device was worn incorrectly.
The open-access study, “Breaking the Cycle of Recurrent Diabetic Foot Ulceration: A Novel and Sustainable Offloading Modality to Treat Diabetic Foot Ulceration and Prevent Recurrence,” was published in the journal Wound.