Offloading in ulcer prevention and its relapse

Neil Baker, Jill Cundell

Research output: Contribution to journalArticle

Abstract

The term “offloading” is generally given to techniques employed in the treatment of
active foot ulceration or immobilisation of acute Charcot neuroarthropathy. It can
equally be used for modalities and strategies for the prevention of new and relapse
ulcers. In this context, perhaps the term “deleterious force management” would
be better suited. Preventing the first ulcer is the ultimate goal of risk screening and
stratification thus understanding the mechanisms for ulceration should direct clinicians
to employ timely and appropriate offloading strategies. The rate of ulcer relapse is very
high with reported rates of 40% in 4–12 months and 70% in 3 years. Managing healed
ulcers is complex and requires considerable understanding and sustained activity.
Central to all of this is active patient involvement and unhindered, easy access to foot
protection teams, as well as adequate resource allocation. It is the authors’ view that
sadly perhaps more focus is placed upon ulcer healing rather than preventing relapse.
This article will briefly explore the area of “offloading” in the prevention of ulceration
and its relapse. When reading this article, it would be useful to bear in mind some of the concepts that were previously discussed in the authors’ article in The Diabetic Foot Journal 19(4), ‘The principles and practicalities of offloading diabetic foot ulcers’.
LanguageEnglish
Pages34 -42
Number of pages9
JournalThe Diabetic Foot Journal
Volume20
Issue number1
Publication statusPublished - 2017

Fingerprint

Secondary Prevention
Ulcer
Diabetic Foot
Recurrence
Patient Participation
Resource Allocation
Immobilization
Foot
Reading
Therapeutics

Keywords

  • Initial and relapse ulcers
  • Prevention
  • Offl oading/Force management

Cite this

Baker, Neil ; Cundell, Jill. / Offloading in ulcer prevention and its relapse. 2017 ; Vol. 20, No. 1. pp. 34 -42.
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Baker, N & Cundell, J 2017, 'Offloading in ulcer prevention and its relapse', vol. 20, no. 1, pp. 34 -42.

Offloading in ulcer prevention and its relapse. / Baker, Neil; Cundell, Jill.

Vol. 20, No. 1, 2017, p. 34 -42.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Offloading in ulcer prevention and its relapse

AU - Baker, Neil

AU - Cundell, Jill

PY - 2017

Y1 - 2017

N2 - The term “offloading” is generally given to techniques employed in the treatment ofactive foot ulceration or immobilisation of acute Charcot neuroarthropathy. It canequally be used for modalities and strategies for the prevention of new and relapseulcers. In this context, perhaps the term “deleterious force management” wouldbe better suited. Preventing the first ulcer is the ultimate goal of risk screening andstratification thus understanding the mechanisms for ulceration should direct cliniciansto employ timely and appropriate offloading strategies. The rate of ulcer relapse is veryhigh with reported rates of 40% in 4–12 months and 70% in 3 years. Managing healedulcers is complex and requires considerable understanding and sustained activity.Central to all of this is active patient involvement and unhindered, easy access to footprotection teams, as well as adequate resource allocation. It is the authors’ view thatsadly perhaps more focus is placed upon ulcer healing rather than preventing relapse.This article will briefly explore the area of “offloading” in the prevention of ulcerationand its relapse. When reading this article, it would be useful to bear in mind some of the concepts that were previously discussed in the authors’ article in The Diabetic Foot Journal 19(4), ‘The principles and practicalities of offloading diabetic foot ulcers’.

AB - The term “offloading” is generally given to techniques employed in the treatment ofactive foot ulceration or immobilisation of acute Charcot neuroarthropathy. It canequally be used for modalities and strategies for the prevention of new and relapseulcers. In this context, perhaps the term “deleterious force management” wouldbe better suited. Preventing the first ulcer is the ultimate goal of risk screening andstratification thus understanding the mechanisms for ulceration should direct cliniciansto employ timely and appropriate offloading strategies. The rate of ulcer relapse is veryhigh with reported rates of 40% in 4–12 months and 70% in 3 years. Managing healedulcers is complex and requires considerable understanding and sustained activity.Central to all of this is active patient involvement and unhindered, easy access to footprotection teams, as well as adequate resource allocation. It is the authors’ view thatsadly perhaps more focus is placed upon ulcer healing rather than preventing relapse.This article will briefly explore the area of “offloading” in the prevention of ulcerationand its relapse. When reading this article, it would be useful to bear in mind some of the concepts that were previously discussed in the authors’ article in The Diabetic Foot Journal 19(4), ‘The principles and practicalities of offloading diabetic foot ulcers’.

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