Difference between Surgical Offloading and Mechanical Offloading in Treatment of Planter Diabetic Foot Ulcer

Abstract

Background: Peripheral neuropathy is a common complication of diabetes. Loss of
protective pain sensation results in plantar diabetic foot pressure ulcers due to recurrent shear and
tear forces. Offloading the pressure from the sole of the foot is crucial in the healing process of
those ulcers. Objective:To review different of offloading in the treatment of in the healing of
pressure, to evaluate the critical of each modality in the healing process and the safety of each
modality.Patients and Methods:This prospective non-randomized comparative study which
included 30 diabetic patients with chronic non-ischaemic non- healed plantar pressure ulcers; 15
of them was managed by surgical offloading methods and 15 of them with non-surgical (air
walker and therapeutic foot shoes).They were followed up for ulcer healing for 6
months.Results:In the surgical group 86.7% had a completely healed pressure ulcers while in the
non-surgical patients 80% had a healed pressure ulcers at the end of follow up period (6 months).
Complications we faced during follow up period were infection, recurrence and nonhealing.Conclusions: Either surgical or non-surgical modalities could be used without significant
difference between them in their outcome. We should tailor the most suitable method for every
patient.