Offloading of diabetes-related neuropathic foot ulcers at Swedish prosthetic and orthotic clinics.
Diabetes Metab Res Rev
; 39(4): e3611, 2023 05.
Article
em En
| MEDLINE
| ID: mdl-36653883
ABSTRACT
AIMS:
This study aimed to assess (1) the use of different offloading interventions in Sweden for the healing of diabetes-related plantar neuropathic forefoot ulcers, (2) factors influencing the offloading intervention choice, and (3) the awareness of current gold standard offloading devices.METHODS:
An online questionnaire was distributed via SurveyMonkey to 51 prosthetic and orthotic clinics in Sweden.RESULTS:
Thirty-five (69%) practitioners responded to the questionnaire. Eighty-six percent of the practitioners provided modified off-the-shelf footwear combined with insoles to treat diabetes-related plantar neuropathic forefoot ulcers. A total contact cast (TCC) was provided by 20% of the practitioners, and a nonremovable knee-high walker was provided by 0%. Multiple practitioner-, patient-, intervention-, and wound-related factors were considered when practitioners provided offloading interventions to patients with this type of ulcer. The majority of the practitioners did not or were unsure whether they considered TCC or a nonremovable knee-high walker to be the gold standard treatment.CONCLUSIONS:
Practitioners mainly provided the offloading intervention that the International Working Group on the Diabetic Foot strongly recommends not be provided, namely, modified off-the-shelf footwear with insoles. In contrast, TCC and nonremovable knee-high walkers, as the gold standards, were vastly underutilised. Therefore, the pattern of providing offloading interventions was almost exactly opposite to the recommendations of evidence-based guidelines. Different factors were considered when providing offloading interventions to patients with diabetes-related plantar neuropathic forefoot ulcers. The practitioners' lack of awareness regarding gold standard devices may have contributed to the underutilisation of TCC and nonremovable knee-high walkers.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Pé Diabético
/
Diabetes Mellitus
Tipo de estudo:
Etiology_studies
/
Guideline
/
Qualitative_research
Limite:
Humans
País/Região como assunto:
Europa
Idioma:
En
Ano de publicação:
2023
Tipo de documento:
Article