Offloading for DFUs

American Limb Preservation Society
Introduction
Recognizing the impact of altered biomechanics in contributing to the development and deterioration of diabetic foot ulcerations, we have noted a few pertinent systematic reviews as well as recently published guidelines on offloading interventions in these high-risk populations.
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Guidelines on offloading foot ulcers in persons with diabetes (IWGDF 2019 update).

Bus SA, Armstrong DG, Gooday C, et al.Diabetes Metab Res Rev. 2020;36 Suppl 1:e3274.
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Effectiveness of offloading interventions to heal foot ulcers in persons with diabetes: a systematic review.

Lazzarini PA, Jarl G, Gooday C, et al.Diabetes Metab Res Rev. 2020;36 Suppl 1:e3275.
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Footwear and offloading interventions to prevent and heal ulcers and reduce plantar pressure in patients with diabetes: a systematic review.

Bus SA, van Deursen RW, Armstrong DG.Diabetes Metab Res Rev. 2016;32 Suppl 1:99-118.
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Comparison of removable and irremovable walking boot to total contact casting in offloading the neuropathic diabetic foot ulceration.

Piaggesi A, Goretti C, Iacopi E, et al.Foot Ankle Int. 2016;37(8):855-61.
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The role of activity, adherence, and off-loading on the healing of diabetic foot wounds.

Wu SC, Armstrong DG.Plast Reconstr Surg. 2006;117(7 Suppl):248S-253S.
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Validation of a diabetic foot surgery classification.

Armstrong DG, Lavery LA, Frykberg RG, Wu SC, Boulton AJM.Int Wound J. 2006;3(3):240-6.
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