Nonsurgical Offloading of the Diabetic Foot

One of the most important fundamental cornerstones in treating diabetic foot ulcers involves offloading plantar pressure. Many dressings and devices have been developed with variable success rates secondary to design and patient adherence and tolerance of the designs. The current gold standard involves use of total contact casting or an irremovable cast walker. Following successful healing of a diabetic foot ulcer, devices such as custom orthotics and shoes are essential to reduce plantar pressures implicated in these wounds' recurrence.