Surgical Offloading versus Medical Conservative Methods in Management of Diabetic Foot Plantar Ulcers (Interventional Study)

Abstract

Background: As a result, peripheral neuropathy is frequently caused by diabetes (DM). Diabetic plantar foot pressure ulcers develop from the lack of protective pain sensibility as a result of recurrent shear and tear pressures. Relieving pressure on the foot's sole is necessary for the ulcers to heal. Objective: This study aimed to test the effectiveness of surgical and non-surgical unloading procedures in healing of plantar ulcers. Subjects and methods: 50 diabetic foot ulcer patients who visited Ain Shams University, The National Institute of DM, and the Endocrinology Outpatient Clinic participated in this interventional trial (NIDE). We employed mechanical and surgical unloading methods in this trial, and patients were monitored for 6 months to see how long it took for their injuries to recover. Results: At the conclusion of the follow-up period, 88% of the surgical group's pressure ulcers were fully healed compared to 86.7% of the non-surgical patients (6 months). Infection, recurrence, and non-healing were complications we encountered throughout the follow-up period. Regarding the treatment of plantar diabetic foot ulcers (DFUs), offloading is crucial. Compared to using only non-surgical methods, surgical offloading may hasten the recovery time. A well-trained team is necessary to prevent the issues with improperly fitting footwear and to teach the patient how to use them on a regular basis with the non-surgical offloading technique.