Comparison between Surgical Offloading and Mechanical Offloading in Treatment of Planter Diabetic Foot Ulcer

Abstract

Background: Diabetes is a systemic disease that affects all body systems and is a major cause of death. Foot problems are a source of major patient suffering and societal costs. Foot ulcers are the most prevalent problem, with a yearly incidence of around 2-4% in developed countries and likely even higher in developing countries. Objective: This study aimed to evaluate the clinical outcome of both surgical and non-surgical methods of offloading in the treatment of neuropathic non-ischaemic plantar pressure ulcers. Materials and methods: This prospective non-randomized comparative study was conducted on 30 patients who presented at the Outpatient Clinic of the Department of General Surgery at Zagazig University Hospital and Department of Vascular and Endovascular Surgery, National Institute of Diabetes and Endocrinology (NIDE). The study was conducted through the period from July 2019 till September 2019. All of them had an offloading method; 15 surgical, 15 non-surgical (walkers or shoes). They had followed up for six months. Results: Successful rate for ulcers healing were 86.7% and 88% for surgical vs. non-surgical methods respectively. Conclusion: Offloading is very important and effective in treatment of pressure unhealed plantar ulcers. Every patient should receive his tailored method of offloading. Surgical offloading is a faster way.