Diabetic Foot Ulcer Clinical Trial
Official title:
Offloading Interventions for Diabetic Foot Problems in Upper Egypt
Offloading is the concept of relieving pressure to help prevent/cure plantar ulcers, especially in diabetic patients. Many forms of offloading are available, with many limitations to apply in clinical practice. In this study, the investigators compare cast shoe with removable walker considering effectiveness, complications, compliance and patient's appreciation.
Abnormal glucose metabolism gradually impairs sensation in both feet. Impaired sensation
leads to recurrent attacks of inflammation "acute Charcot arthritis". Eventually, the foot
becomes deformed with abnormal shape of the plantar surface. During walking, both neuropathy
and deformities cause abnormal distribution of pressure with some points in the plantar
surface having a very high pressure. This high pressure leads to skin ulceration "pressure
ulcer". These pressure ulcers tend to be recurrent or chronic as long as the problem of high
pressure is not resolved.
Offloading techniques are pressure-relieving interventions that redistribute body weight over
the plantar surface. Areas with high pressure which are at high risk of ulceration, are
treated to decrease pressure and cure ulcers.
The diabetic foot clinic at Assiut university hospital provides patients with necessary care
to avoid the single most fearsome enemy, amputation. This clinic currently provides many
offloading options based on expert opinion, and there is an urgent need to have a
well-balanced view supported by evidence, considering both the physician and the patient.
The investigators' project is to conduct a series of trials to guide policies concerned with
diabetic foot problems, OIDFUA. This study will compare cast shoe with removable walker, as
different offloading options to cure diabetic foot ulcers.
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