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Diabetes and Wound Offloading

As a diabetic, it is important for you to look after your feet because any wound that form under your foot will take longer to heal due to the circulatory issues you have or may develop. It is this circulatory issue that delays and limits healing and your body’s immune response to the wound, resulting in the formation of a diabetic foot ulcer. This ulcer may not heal without the proper wound care and orthotic interventions which will lead to a prolonged healing process resulting in a higher risk of infection. In more sever cases, the infection can quickly spread to the bone which will lead to amputation or become life-threatening.

Some diabetics may also have sensory neuropathy which limits the sensation/feeling you have in your lower limbs and feet. The lack of sensation in your feet can result in you not being aware of an increase in friction/shear forces or pressure acting on the soles of the feet. This lack of sensation/feeling can lead to you developing a blister under the foot that can develop further into an ulcer without proper interventions. It is advised for patients with diabetic neuropathy to walk bear foot and to wear diabetically friendly shoes and socks to reduce the chance of sustaining minor injuries to the feet.

We have a variety of orthotic devices ranging from total contact foot orthotics, designed to reduce shear forces to the soles of your feet, as well as diabetic shoes and socks. Should you develop an ulcer or have an existing one we have specially designed offloading shoes and foot orthotics to help off load the wound site and promote healing. These wound sites need to be constantly monitored and the insoles may need to be adjusted to provide as much support and offloading as possible. 

Some diabetics may also have sensory neuropathy which limits the sensation/feeling you have in your lower limbs and feet. The lack of sensation in your feet can result in you not being aware of an increase in friction/shear forces or pressure acting on the soles of the feet. This lack of sensation/feeling can lead to you developing a blister under the foot that can develop further into an ulcer without proper interventions. It is advised for patients with diabetic neuropathy to walk bear foot and to wear diabetically friendly shoes and socks to reduce the chance of sustaining minor injuries to the feet.

We have a variety of orthotic devices ranging from total contact foot orthotics, designed to reduce shear forces to the soles of your feet, as well as diabetic shoes and socks. Should you develop an ulcer or have an existing one we have specially designed offloading shoes and foot orthotics to help off load the wound site and promote healing. These wound sites need to be constantly monitored and the insoles may need to be adjusted to provide as much support and offloading as possible. 

Available orthotic treatments
The treatment objectives for an ulcer on your foot or feet:

CROW Boots

CROW (Charcot Restraint Orthotic Walker) is a cross between an ankle-foot orthosis and a custom boot designed to provide total contact for weight distribution. Its bi-valve design provides a total contact fit over your shin, calf, and foot. It has soft padding on the inside, and the sole is covered with a material like shoe soling. It is not worn with a shoe. Due to the limited movement within the boot is sometimes required to help unload an ulcer and promote healing. They may also be used post operatively when a standard fracture boot is not fit for purpose. 

CROW Boots are indicated for:

SBI MOTUS 2.0 Walker Boot

The SBi Motus 2.0 is a high ankle/foot rocker offloading boot for the treatment of diabetic foot ulcers and wound off-loading.

The Motus boot is made from a durable lightweight frame that incases a breathable heat mouldable liner that can be custom fitted to you to ensure optimal function and comfort.

The “fully rocking” sole was developed to be stable while providing maximum pressure offloading under the plantar surface of the foot which will greatly improve wound healing. The fully rocking sole can be removed and replaced with a “normal rocking” sole for when the wound has healed, and the “fully rocking” sole is not needed any more.

The SBi Motus boot has a modular design, meaning that the boot consists out of different parts and sections that can be removed and replaced to allow easy modifications to the boot as wound off-loading needs change over time.

Indications
Clinical features

Post-Operative and Wound Offloading Shoes

These shoes are not side specific and are generally wider and longer than a standard shoe to allow for bulky dressing post operatively or for dressing for a wound or wounds. They have a have a wide Velcro forefoot closure to allow for maximum adjustment. 

Wedged shoes – designed to reduce forefoot loading by shifting weight to the mid and rear foot such as the Remedy Pro Shoe from DJO. 

Offloading footwear shoes – designed to provide pressure redistribution or offloading for patients at-risk for diabetic foot conditions such as neuropathic ulcers and Charcot foot. 

Post-Operative Shoes – designed to be lightweight, universal in fit, wide, and accommodating to promote healing post operatively. 

Remedy pro shoe – DJO Offloading diabetic shoe – DJO
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Dr Comfort Annie Dr Comfort Performance
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