Offloading is the most important principle in treating diabetic foot ulcers and without it, the wound will not heal even with the best dressings and antibiotics. The principle is simple: you cannot heal a wound you are standing on!
Why Offloading Is Essential:
Most diabetic foot ulcers occur in high-pressure areas — the sole under metatarsal heads, heel, and big toe. Standing and walking on the ulcer prevents healing and increases its size.
Offloading Methods:
- Total Contact Cast (TCC): The gold standard — a plaster cast encasing the entire foot that distributes pressure evenly. Reduces pressure on the ulcer by 60-80%.
- Therapeutic medical shoe: Special shoe with rigid sole and hollow area under the ulcer.
- Half shoes: Bear weight on heel only and elevate the forefoot.
- Wheelchair or crutches: In severe cases — completely avoid walking on the affected foot.
- Custom insoles: Made to foot shape after ulcer healing to prevent recurrence.
At BEIT TARIQ Center, we select the most appropriate offloading method for each patient based on ulcer location, severity, and patient activity level.