Surgical Offloading in the Diabetic Foot

Diabetic foot ulcers are severe complications of diabetes resulting in high health care costs and reduced quality of life. Persistent mechanical pressure, neuropathy, foot deformity, and patient comorbidities contribute to the ulcer formation and poor healing. While nonsurgical offloading techniques are common, they are associated with noncompliance, skin irritation, and limited wound assessment capability. Surgical offloading offers a direct approach in reducing and redistributing pressures to promote ulcer healing. Its success depends on proper patient selection, glycemic control, and postoperative care. When combined with multidisciplinary management, surgical offloading plays a pivotal role in promoting healing, reducing infection, and preventing infections.