Offloading of diabetes-related neuropathic foot ulcers at Swedish prosthetic and orthotic clinics

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Gigante, IsabellaGothenburg University,Göteborgs universitet,Institutionen för kliniska vetenskaper, Avdelningen för ortopedi,Institute of Clinical Sciences, Department of Orthopaedics,The Department of Orthopaedics, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden (författare)

Offloading of diabetes-related neuropathic foot ulcers at Swedish prosthetic and orthotic clinics

Artikel/kapitelEngelska2023

Förlag, utgivningsår, omfång ...

2023-02-02
Wiley,2023

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LIBRIS-ID:oai:gup.ub.gu.se/324586
https://gup.ub.gu.se/publication/324586URI
https://doi.org/10.1002/dmrr.3611DOI
https://urn.kb.se/resolve?urn=urn:nbn:se:oru:diva-103317URI

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Språk:engelska

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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 non-removable 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.

Ämnesord och genrebeteckningar

MEDICIN OCH HÄLSOVETENSKAP Klinisk medicin Endokrinologi och diabetes hsv//swe
MEDICAL AND HEALTH SCIENCES Clinical Medicine Endocrinology and Diabetes hsv//eng
diabetic foot
diabetic foot ulcers
evidence-based guidelines
offloading
orthotics
plantar forefoot ulcer
Plantar forefoot ulcer

Biuppslag (personer, institutioner, konferenser, titlar ...)

Sigurjonsdottir, E. D.Department of Prosthetics and Orthotics, Stoð, Hafnarfjörður, Iceland (författare)
Jarl, Gustav,1978-Region Örebro län,Örebro universitet, Institutionen för hälsovetenskaper,Department of Prosthetics and Orthotics, Faculty of Medicine and Health, Örebro University, Örebro, Sweden; University Health Care Research Center, Faculty of Medicine and Health, Örebro University, Örebro, Sweden(Swepub:oru)gjl (författare)
Hellstrand Tang, Ulla,1956Gothenburg University,Göteborgs universitet,Institutionen för kliniska vetenskaper, Avdelningen för ortopedi,Institute of Clinical Sciences, Department of Orthopaedics,The Department of Orthopaedics, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; The Department of Prosthetics and Orthotics, Sahlgrenska University Hospital, Gothenburg, Sweden(Swepub:gu)xhellu (författare)
Göteborgs universitetInstitutionen för kliniska vetenskaper, Avdelningen för ortopedi (creator_code:org_t)

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Ingår i:Diabetes-Metabolism Research and Reviews: Wiley1520-75521520-7560

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