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An innovative sealed shoe to off-load and heal diabetic forefoot ulcers - a feasibility study
Örebro University, School of Medical Sciences. Örebro University Hospital. Department of Prosthetics and Orthotics, Faculty of Medicine and Health, Örebro University, Örebro, Sweden; University Health Care Research Center, Faculty of Medicine and Health, Örebro University, Örebro, Sweden..
Department of Orthopaedics, Institute of Clinical Sciences, The Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden.
2017 (English)In: Diabetic Foot & Ankle, ISSN 2000-625X, Vol. 8, no 1, 1348178Article in journal (Refereed) Published
Abstract [en]

Background: Non-removable knee-high devices are the gold standard to treat diabetic foot ulcers located on the plantar forefoot, but they immobilize the ankle, which restricts daily life activities and has negative effects on joint functioning. Objective: To investigate the feasibility of sealing a therapeutic shoe to off-load and heal diabetic forefoot ulcers. Design: A case series of seven men with type 2 diabetes and a metatarsal head ulcer were prescribed therapeutic shoes and custom-made insoles. The shoe was sealed with a plastic band. Off-loading was assessed with the F-scan pressure measurement system. Adherence to wearing the shoe was assessed with a temperature sensor and by documenting the status of the seal. Results: The off-loading was effective and all ulcers healed. Median time to healing was 56 days (range 8-160). Complications were secondary ulcer (n = 1) and plantar hematoma (n = 1). Five of seven participants did not disturb the seal. Conclusions: Sealing a therapeutic shoe is a feasible way to off-load and heal forefoot ulcers. A controlled trial is needed to compare the effectiveness and safety of a sealed shoe to other non-removable devices.

Place, publisher, year, edition, pages
2017. Vol. 8, no 1, 1348178
Keyword [en]
Diabetic foot, diabetes complications, diabetes mellitus, orthotic devices, patient compliance, shoes, ulcer
National Category
Orthopaedics
Identifiers
URN: urn:nbn:se:oru:diva-61722DOI: 10.1080/2000625X.2017.1348178PubMedID: 28804593Scopus ID: 2-s2.0-85026290776OAI: oai:DiVA.org:oru-61722DiVA: diva2:1155244
Available from: 2017-11-07 Created: 2017-11-07 Last updated: 2017-11-07Bibliographically approved

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Jarl, Gustav

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