Offloading Intervention

Margaret Heale's picture
Details

By Margaret Heale, RN, MSc, CWOCN

In our point, click, fill-in-the -blanks world of ever increasing wound care algorithms and MOs, I have an ax to grind (straight into my so-called smart phone if I had the courage).

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James McGuire's picture
View of Pressure Points on a Foot

by James McGuire, DPM, PT, LPed, FAPWH

Editor's note:This blog post is part of the WoundSource Trending Topics series, bringing you insight into the latest clinical issues and advancement in wound management, with contributions by the WoundSource Editorial Advisory Board.

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Laurie Swezey's picture
total contact casting

by Laurie Swezey RN, BSN, CWOCN, CWS, FACCWS

Total contact casting (TCC) is considered to be the 'gold standard' in the treatment of diabetic foot ulcers. Although TCC is often very successful in healing diabetic foot ulcers, this treatment modality is not used as often as it could be.

Mark Hinkes's picture
leg bones

by Dr. Mark Hinkes, DPM

Unequal limb length (ULL) is a clinical problem that is more common than most clinicians realize and is one for which most patients are rarely evaluated. Common problems associated with unequal limb length include instability in gait, falling, low back pain, sciatica, joint pain, IT Band Syndrome, chronic muscle strain, tendonitis, and failure of diabetic foot wounds to heal.

Temple University School of Podiatric Medicine's picture

by Rizwan Tai and James McGuire DPM, PT, CPed, FAPWHc

According to Centers for Disease Control and Prevention (CDC), the number of adults between the ages of 18-79 with newly diagnosed diabetes has more than tripled in the last 30 years. Foot ulcers are a major complication of uncontrolled diabetes, and 25% of the patients will be affected with foot ulcers in their lifetime, the majority of which lead to lower extremity amputations.

Aletha Tippett MD's picture

by Aletha Tippett MD

The great medical pioneer, Dr. Paul Brand, was right when he said it's not about medicine, it's about mechanics. Think of the ulcers you are asked to see and treat. I hope the first question you ask about any wound is "how did this get here?" If the mechanics of a wound are not addressed, the medicine will not be successful.

Laurie Swezey's picture

by Laurie Swezey RN, BSN, CWOCN, CWS, FACCWS

Pressure mapping has traditionally been used by physiotherapists, occupational therapists, chiropractors, orthotists and other health professionals to determine where pressure might become an issue for a patient and how to redistribute skin-damaging pressure for the prevention of pressure ulcers.

How does pressure mapping work?

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James McGuire's picture

James McGuire DPM, PT, CPed, FAPWCA

It is essential that the various offloading devices available to the wound care professional are applied appropriately to redistribute destructive forces that develop in the diabetic or neuropathic foot during standing and ambulation.1,2 The 6 "W" approach was first introduced in an article in 20063 to help practitioners better understand the biomechanical risk profile of patients at risk for ulceration so that they could better choose between the various offloading interventions available for their everyday footwear.