The edge effect: how and why wounds grow in size and depth

The central tenet for healing any wound is pressure redistribution and appropriate débridement. It is generally not what you put on these wounds that heals them, but rather what you take off. If the wound is adequately débrided and plantar pressure is redistributed, in the absence of profound ischemia, most diabetic foot wounds will heal. Off-loading is best achieved by spreading force over a wide area of contact, such as with the total contact cast or certain removable cast walkers.