Bus et al. 2023
Back to overview
Bus SA, Armstrong DG, Crews RT, Gooday C, Jarl G, Kirketerp-Moller K, Viswanathan V, Lazzarini PA. Guidelines on offloading foot ulcers in persons with diabetes (IWGDF 2023 update). Diabetes Metab Res Rev. 2023 May 25:e3647.
Design: Evidence-based Guidelines Methods: A multidisciplinary working group of independent international experts in offloading DFU were invited to develop this guideline. A series of clinical questions was devised, and a systematic review and meta-analysis of studies was performed to develop summaries and recommendations for each question. This encompassed factors such as certainty of evidence, cost- effectiveness, patient values, desirable/undesirable effects, feasibility etc. Results: Recommendations included: • For plantar forefoot or midfoot ulcer healing, use a non-removable knee-high offloading device (including total contact casts and removable knee-high walkers rendered non-removable) as the first-choice offloading intervention. • For patient intolerance or contraindications, use a removable knee-high walker as second-choice. • For non-plantar ulcers, use a removable offloading device, footwear modifications, toe spacers, orthoses or digital flexor tenotomy depending on the type and location of the foot ulcer. • For infected ulcers, primarily deal with the infection and then use a removable offloading intervention.
Key message: Offloading interventions are arguably one of the, if not the, most important interventions with the highest 'certainty of evidence' available for healing neuropathic DFUs and reducing the global burden of these ulcers.
iEnovis
Pubmed
Figures
15
© 2022 Enovis Corporation
CONFIDENTIAL
Made with FlippingBook - PDF hosting