Offloading Foot Wounds in People With Diabetes

David G. Armstrong, DPM, MD, PhD; Adam L. Isaac, DPM; Nicholas J. Bevilacqua, DPM; Stephanie C. Wu, DPM, MS


Wounds. 2014;26(1):13-20. 

In This Article


It is important to understand that while the recent history of treatment of wounds in general—and wounds in people with diabetes specifically—has been marked by some exciting advances on the high-technology front, it is in fact the low-technology systematic aspects of care that must assume priority. Wound care professionals often say, "It's not what one puts on a wound that heals it, but what one takes off." Appropriate wound care, debridement, and pressure reduction have and will continue to be the cornerstones of treatment. The key to successful pressure reduction possibly lies more in patient adherence than in the prescribed offloading devices. Individuals with diabetes who have lost the "gift of pain" may not always adhere to the offloading regimen. Combining an effective, easy-to-use offloading device that ensures patient compliance with advanced wound healing modalities may form a formidable team in healing ulcers and potentially averting lower-limb amputations.