Guidelines on offloading foot ulcers in persons with diabetes—IWGDF 2023 update.
Open accessAbstract
AIMS: Offloading mechanical tissue stress is arguably the most important of multiple interventions needed to heal diabetes-related foot ulcers. This is the 2023 International Working Group on the Diabetic Foot (IWGDF) evidence-based guideline on offloading interventions to promote healing of foot ulcers in persons with diabetes. It serves as an update of the 2019 IWGDF guideline. MATERIALS AND METHODS: We followed the GRADE approach by devising clinical questions and important outcomes in the PICO (Patient-Intervention-Control-Outcome) format, undertaking a systematic review and meta-analyses, developing summary of judgement tables and writing recommendations and rationales for each question. Each recommendation is based on the evidence found in the systematic review, expert opinion where evidence was not available, and a careful weighing of GRADE summary of judgement items including desirable and undesirable effects, certainty of evidence, patient values, resources required, cost effectiveness, equity, feasibility, and acceptability. RESULTS: For healing a neuropathic plantar forefoot or midfoot ulcer in a person with diabetes, use a non-removable knee-high offloading device as the first-choice offloading intervention. If contraindications or patient intolerance to non-removable offloading exist, consider using a removable knee-high or ankle-high offloading device as the second-choice offloading intervention. If no offloading devices are available, consider using appropriately fitting footwear combined with felted foam as the third-choice offloading intervention. If such a non-surgical offloading treatment fails to heal a plantar forefoot ulcer, consider an Achilles tendon lengthening, metatarsal head resection, joint arthroplasty, or metatarsal osteotomy. For healing a neuropathic plantar or apex lesser digit ulcer secondary to flexibile toe deformity, use digital flexor tendon tenotomy. For healing rearfoot, non-plantar or ulcers complicated with infection or ischaemia, further recommendations have been outlined. All recommendations have been summarised in an offloading clinical pathway to help facilitate the implementation of this guideline into clinical practice. CONCLUSION: These offloading guideline recommendations should help healthcare professionals provide the best care and outcomes for persons with diabetes-related foot ulcers and reduce the person's risk of infection, hospitalisation and amputation.
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
A toe systolic blood pressure less than 30 mm Hg had a 2.09 times higher relative risk of a nonhealing wound post-amputation compared with values of 30 mm Hg or greater (95% CI, 1.37-3.20).
“Another meta-analysis of 4 studies with 104 patients reported that a toe systolic blood pressure less than 30 mm Hg had a 2.09 times higher relative risk (RR) of a nonhealing wound post-amputation compared with values of 30 mm Hg or greater (95% CI, 1.37-3.20;P = .001[absolute rates not provided]).46”
From Diabetic Foot Ulcers (2023) · cites this paper as [46]
The surgical-offloading rationale discusses ulcer healing and amputations, but does not report toe systolic pressure or wound healing after amputation. Searches for the 30 mm Hg threshold and the reported relative risk found no passage addressing the claimed meta-analysis. (LLM, conf=0.76)
Experimental — accuracy not yet measuredToe systolic blood pressure <30 mm Hg is associated with 2.09-fold higher relative risk of nonhealing after partial foot amputation compared with values ≥30 mm Hg (relative risk, 2.09; 95% CI, 1.37-3.20; P =.001).
“Toe systolic blood pressure <30 mm Hg is associated with 2.09-fold higher relative risk of nonhealing after partial foot amputation compared with values ≥30 mm Hg (relative risk, 2.09; 95% CI, 1.37-3.20;P =.001).”
From Diabetic Foot Ulcers (2023) · cites this paper as [46]
The surgical-offloading rationale (page not provided) discusses ulcer healing and amputations after offloading interventions, but not toe systolic blood pressure as a predictor of healing after partial foot amputation. Searches for the 30 mm Hg threshold, the reported relative risk and confidence interval, and toe systolic blood pressure found no passage addressing the claim. (LLM, conf=0.76)
Experimental — accuracy not yet measuredToe systolic blood pressure measurement is 86% sensitive and 58% specific.
“Toe systolic blood pressure 46,47 Measurement of systolic blood pressure at the toe 86% sensitive; 58% specific”
From Diabetic Foot Ulcers (2023) · cites this paper as [46]
The cited guideline discusses offloading devices and plantar pressure (Below ankle-high offloading device, p. 6), not the diagnostic accuracy of toe systolic blood pressure measurement. Searches for toe systolic blood pressure and the stated 86% sensitivity and 58% specificity found no passage addressing those figures. (LLM, conf=0.76)
Experimental — accuracy not yet measured
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Cites
GRADE: an emerging consensus on rating quality of evidence and strength of recommendations
Guyatt, G. H., Oxman, A. D., Vist, G. E., Kunz, R., Falck-Ytter, Y., Alonso-Coello, P., & Schünemann, H. J. (2008) · BMJ · doi:10.1136/bmj.39489.470347.ad · Cited by 23,305 · cited 1× · see citing works
“33,34 The methodology for this guideline is summarised below; we refer those seeking a more detailed BUS ET AL . description on the methods for developing and writing these guidelines to the ‘IWGDF Guidelines development and methodology’ document.”
MethodDiabetic foot ulcers and their recurrence
Armstrong, D. G., Boulton, A. J. M., & Bus, S. A. (2017) · New England Journal of Medicine · doi:10.1056/nejmra1615439 · Cited by 4,376 · see citing works
Self-citationThe global burden of diabetic foot disease
Boulton, A. J. M., Vileikytė, L., Tennvall, G. R., & Apelqvist, J. (2005) · The Lancet · doi:10.1016/s0140-6736(05)67698-2 · Cited by 2,578 · see citing works
Prompers, L., Huijberts, M., Apelqvist, J., Jude, E., Piaggesi, A., Bakker, K., Edmonds, M., Holstein, P., Jirkovska, A., Mauricio, D., et al. (2007) · Diabetologia · doi:10.1007/s00125-006-0491-1 · Cited by 1,023 · see citing works
Alonso-Coello, P., Oxman, A. D., Moberg, J., Brignardello-Petersen, R., Akl, E. A., Davoli, M., Treweek, S., Mustafa, R. A., Vandvik, P. O., Meerpohl, J., et al. (2016) · BMJ · doi:10.1136/bmj.i2089 · Cited by 814 · cited 2× · see citing works
“33,34 Fifth, summary of judgements tables and recommendations for each question were extensively discussed in online meetings with the working group.”
BackgroundMethodGlobal Disability Burdens of Diabetes-Related Lower-Extremity Complications in 1990 and 2016
Zhang, Y., Lazzarini, P. A., McPhail, S., van Netten, J. J., Armstrong, D. G., & Pacella, R. (2020) · Diabetes Care · doi:10.2337/dc19-1614 · Cited by 594 · see citing works
Self-citationSchaper, N. C., van Netten, J. J., Apelqvist, J., Bus, S. A., Fitridge, R., Game, F., Monteiro‐Soares, M., Senneville, E., & the IWGDF Editorial Board (2024) · Diabetes/Metabolism Research and Reviews · doi:10.1002/dmrr.3657 · Cited by 583 · see citing works
Self-citationCurrent challenges and opportunities in the prevention and management of diabetic foot ulcers.
Jeffcoate, W. J., Vileikyte, L., Boyko, E. J., Armstrong, D. G., & Boulton, A. J. M. (2018) · Diabetes Care · doi:10.2337/dc17-1836 · Cited by 475 · see citing works
Self-citationLazzarini, P. A., Pacella, R., Armstrong, D. G., & van Netten, J. J. (2018) · Diabetic Medicine · doi:10.1111/dme.13680 · Cited by 306 · see citing works
Self-citationGuidelines on the prevention of foot ulcers in persons with diabetes (IWGDF 2023 update)
Bus, S. A., Sacco, I. D. C. N., Monteiro‐Soares, M., Raspovic, A., Paton, J. S., Rasmussen, A., Lavery, L. A., & van Netten, J. J. (2023) · Diabetes/Metabolism Research and Reviews · doi:10.1002/dmrr.3651 · Cited by 298 · see citing works
Self-citationChen, P., Vilorio, N. C., Dhatariya, K., Jeffcoate, W., Lobmann, R., McIntosh, C., Piaggesi, A., Steinberg, J., Vas, P., Viswanathan, V., et al. (2024) · Diabetes/Metabolism Research and Reviews · doi:10.1002/dmrr.3644 · Cited by 246 · see citing works
Fernando, M. E., Crowther, R. G., Lazzarini, P. A., Sangla, K. S., Cunningham, M., Buttner, P. G., & Golledge, J. (2013) · Clinical Biomechanics · doi:10.1016/j.clinbiomech.2013.08.004 · Cited by 243 · see citing works
Self-citationKatz, I. A., Harlan, A., Miranda-Palma, B., Prieto, L. M., Armstrong, D. G., Bowker, J. H., Mizel, M. S., & Boulton, A. J. M. (2005) · Diabetes Care · doi:10.2337/diacare.28.3.555 · Cited by 239 · see citing works
Self-citationGuidelines on offloading foot ulcers in persons with diabetes (IWGDF 2019 update)
Bus, S. A., Armstrong, D. G., Gooday, C., Jarl, G. M., Caravaggi, C. M. F., Viswanathan, V., Lazzarini, P. A., & on behalf of the International Working Group on the Diabetic Foot (IWGDF) (2020) · Diabetes/Metabolism Research and Reviews · doi:10.1002/dmrr.3274 · Cited by 228 · see citing works
Self-citationJeffcoate, W. J., Bus, S. A., Game, F. L., Hinchliffe, R. J., Price, P., & Schaper, N. C. (2016) · The Lancet Diabetes & Endocrinology · doi:10.1016/s2213-8587(16)30012-2 · Cited by 221 · see citing works
Self-citationDefinitions and criteria for diabetes‐related foot disease (IWGDF 2023 update)
van Netten, J. J., Bus, S. A., Apelqvist, J., Chen, P., Chuter, V., Fitridge, R., Game, F. L., Hinchliffe, R. J., Lazzarini, P. A., Mills, J. L., et al. (2023) · Diabetes/Metabolism Research and Reviews · doi:10.1002/dmrr.3654 · Cited by 215 · see citing works
Self-citationUse of Pressure Offloading Devices in Diabetic Foot Ulcers
Wu, S. C., Jensen, J. L., Weber, A. K., Robinson, D. E., & Armstrong, D. G. (2008) · Diabetes Care · doi:10.2337/dc08-0771 · Cited by 207 · see citing works
Self-citationPrompers, L., Huijberts, M. S., Apelqvist, J., Jude, E. B., Piaggesi, A., Bakker, K., Edmonds, M. E., Holstein, P., Jirkovská, A., Mauricio, D., et al. (2008) · Diabetic Medicine · doi:10.1111/j.1464-5491.2008.02445.x · Cited by 203 · see citing works
Guidelines on the classification of foot ulcers in people with diabetes (IWGDF 2023 update).
Monteiro‐Soares, M., Hamilton, E. J., Russell, D. A., Srisawasdi, G., Boyko, E. J., Mills, J. L., Jeffcoate, W., & Game, F. (2024) · Diabetes/Metabolism Research and Reviews · doi:10.1002/dmrr.3648 · Cited by 152 · see citing works
An Off-the-Shelf Instant Contact Casting Device for the Management of Diabetic Foot Ulcers
Piaggesi, A., Macchiarini, S., Rizzo, L., Palumbo, F., Tedeschi, A., Laura, A. N., Leporati, E., Scirè, V., Teobaldi, I., & Prato, S. D. (2007) · Diabetes Care · doi:10.2337/dc06-1750 · Cited by 129 · see citing works
Lazzarini, P. A., Crews, R. T., van Netten, J. J., Bus, S. A., Fernando, M. E., Chadwick, P., & Najafi, B. (2019) · Journal of Diabetes Science and Technology · doi:10.1177/1932296819849092 · Cited by 128 · see citing works
Self-citationThe role of pressure offloading on diabetic foot ulcer healing and prevention of recurrence.
Bus, S. A. (2016) · Plastic & Reconstructive Surgery · doi:10.1097/prs.0000000000002686 · Cited by 118 · see citing works
Wukich, D. K., Schaper, N. C., Gooday, C., Bal, A., Bém, R., Chhabra, A. B., Hastings, M. K., Holmes, C., Petrova, N. L., Araujo, M. G. S., et al. (2023) · Diabetes/Metabolism Research and Reviews · doi:10.1002/dmrr.3646 · Cited by 114 · see citing works
Self-citationFernando, M. E., Crowther, R. G., Pappas, E., Lazzarini, P. A., Cunningham, M., Sangla, K. S., Buttner, P. G., & Golledge, J. (2014) · PLoS ONE · doi:10.1371/journal.pone.0099050 · Cited by 105 · see citing works
Self-citationLazzarini, P. A., Cramb, S. M., Golledge, J., Morton, J. I., Magliano, D. J., & van Netten, J. J. (2022) · Diabetologia · doi:10.1007/s00125-022-05845-9 · Cited by 81 · see citing works
Self-citationKeukenkamp, R., Merkx, M. J. M., Busch‐Westbroek, T. E., & Bus, S. A. (2017) · Journal of the American Podiatric Medical Association · doi:10.7547/16-171 · Cited by 75 · see citing works
Self-citationZhang, Y., Cramb, S. M., McPhail, S., Pacella, R., van Netten, J. J., Cheng, Q., Derhy, P. H., Kinnear, E. M., & Lazzarini, P. A. (2021) · Diabetes Care · doi:10.2337/dc20-3120 · Cited by 61 · see citing works
Self-citationReasons for (non‐)adherence to self‐care in people with a diabetic foot ulcer
van Netten, J. J., Seng, L. S. D., Lazzarini, P. A., Warnock, J. T., & Ploderer, B. (2019) · Wound Repair and Regeneration · doi:10.1111/wrr.12728 · Cited by 60 · see citing works
Self-citationA survey of offloading practices for diabetes-related plantar neuropathic foot ulcers.
Raspovic, A., & Landorf, K. B. (2014) · Journal of Foot and Ankle Research · doi:10.1186/s13047-014-0035-8 · Cited by 58 · see citing works
Lazzarini, P. A., Armstrong, D. G., Crews, R. T., Gooday, C., Jarl, G., Kirketerp‐Moller, K., Viswanathan, V., & Bus, S. A. (2024) · Diabetes/Metabolism Research and Reviews · doi:10.1002/dmrr.3650 · Cited by 57 · see citing works
Quinton, T. R., Lazzarini, P. A., Boyle, F. M., Russell, A. W., & Armstrong, D. G. (2015) · Journal of Foot and Ankle Research · doi:10.1186/s13047-015-0072-y · Cited by 49 · see citing works
Self-citationBinning, J., Woodburn, J., Bus, S. A., & Barn, R. (2018) · Diabetes/Metabolism Research and Reviews · doi:10.1002/dmrr.3105 · Cited by 48 · see citing works
Self-citationJarl, G., van Netten, J. J., Lazzarini, P. A., Crews, R. T., Najafi, B., & Mueller, M. J. (2021) · Diabetes Research and Clinical Practice · doi:10.1016/j.diabres.2021.108733 · Cited by 46 · see citing works
Self-citationFlexor Tenotomy Improves Healing and Prevention of Diabetes-Related Toe Ulcers: A Systematic Review
Bonanno, D. R., & Gillies, E. J. (2017) · The Journal of Foot & Ankle Surgery · doi:10.1053/j.jfas.2017.02.011 · Cited by 41 · see citing works
Ababneh, A., Finlayson, K. J., Edwards, H. E., & Lazzarini, P. A. (2022) · BMJ Open Diabetes Research & Care · doi:10.1136/bmjdrc-2021-002640 · Cited by 35 · see citing works
Self-citationZhang, Y., Carter, H. E., Lazzarini, P. A., Cramb, S. M., Pacella, R., van Netten, J. J., Cheng, Q., Derhy, P. H., Kinnear, E. M., & McPhail, S. (2022) · Diabetic Medicine · doi:10.1111/dme.14961 · Cited by 32 · see citing works
Self-citationLazzarini, P. A., & Jarl, G. M. (2021) · Medicina · doi:10.3390/medicina57090941 · Cited by 31 · see citing works
Self-citationZhang, Y., Cramb, S. M., McPhail, S., Pacella, R., van Netten, J. J., Cheng, Q., Derhy, P. H., Kinnear, E. M., & Lazzarini, P. A. (2022) · Diabetes Research and Clinical Practice · doi:10.1016/j.diabres.2022.109239 · Cited by 31 · see citing works
Self-citationStandards for the development and methodology of the 2023 IWGDF guidelines
Bus, S. A., Monteiro‐Soares, M., Game, F. L., van Netten, J. J., Apelqvist, J., Fitridge, R., Senneville, É., Schaper, N. C., & IWGDF Editorial Board (2023) · Diabetes/Metabolism Research and Reviews · doi:10.1002/dmrr.3656 · Cited by 31 · see citing works
Self-citationFlexor tendon tenotomy treatment of the diabetic foot: a multicenter randomized controlled trial.
Askø Andersen, J., Rasmussen, A., Engberg, S., Bencke, J., Frimodt-Møller, M., Kirketerp-Møller, K., & Rossing, P. (2022) · Diabetes Care · doi:10.2337/dc22-0085 · Cited by 29 · see citing works
Jeffcoate, W. J., Game, F. L., Turtle-Savage, V., Musgrove, A., Price, P., Tan, W., Bradshaw, L. E., Montgomery, A. A., Fitzsimmons, D. F., Farr, A., et al. (2017) · Health Technology Assessment · doi:10.3310/hta21340 · Cited by 25 · see citing works
Total contact casting versus traditional dressing in diabetic foot ulcers
Sahu, B., Prusty, A., & Tudu, B. (2018) · Journal of orthopaedic surgery · doi:10.1177/2309499018802486 · Cited by 23 · see citing works
Training diabetes healthcare practitioners in motivational interviewing: a systematic review
Kaczmarek, T., Kavanagh, D. J., Lazzarini, P. A., Warnock, J. T., & van Netten, J. J. (2021) · Health Psychology Review · doi:10.1080/17437199.2021.1926308 · Cited by 21 · see citing works
Self-citationSelf-Monitoring Diabetes-Related Foot Ulcers with the MyFootCare App: A Mixed Methods Study
Ploderer, B., Clark, D., Brown, R. A., Harman, J., Lazzarini, P. A., & van Netten, J. J. (2023) · Sensors · doi:10.3390/s23052547 · Cited by 21 · see citing works
Self-citationPersonalized Offloading Treatments for Healing Plantar Diabetic Foot Ulcers
Jarl, G. M., Rusaw, D. F., Terrill, A. J., Barnett, C. T., Woodruff, M. A., & Lazzarini, P. A. (2022) · Journal of Diabetes Science and Technology · doi:10.1177/19322968221101632 · Cited by 16 · see citing works
Self-citationWang, Y., Zhou, J., Fen, Y., Li, G., Duan, X., Pan, H., & He, J. (2015) · Medical Science Monitor · doi:10.12659/msm.893677 · Cited by 15 · see citing works
Ventral Windowed Total Contact Casts Safely Offload Diabetic Feet and Allow Access to the Foot
Hochlenert, D., & Fischer, C. (2020) · Journal of Diabetes Science and Technology · doi:10.1177/1932296820964069 · Cited by 12 · see citing works
Mens, M. A., van Netten, J. J., Busch‐Westbroek, T. E., Bus, S. A., Streekstra, G. J., Wellenberg, R. H. H., Maas, M. M., Nieuwdorp, M., & Stufkens, S. A. S. (2021) · Diabetic Medicine · doi:10.1111/dme.14761 · Cited by 12 · see citing works
Self-citationAbabneh, A., Finlayson, K. J., Edwards, H. E., van Netten, J. J., & Lazzarini, P. A. (2023) · Therapeutic Advances in Endocrinology and Metabolism · doi:10.1177/20420188221142457 · Cited by 11 · see citing works
Self-citationPotier, L., François, M., Dardari, D., Feron, M., Belhatem, N., Nobécourt, E., Dolz, M., Bordier, L., Ducloux, R., Chibani, A., et al. (2020) · BMJ Open Diabetes Research & Care · doi:10.1136/bmjdrc-2019-000954 · Cited by 10 · see citing works
Yelland, A. C., Meace, C., Knighton, P., Holman, N., Wild, S. H., Michalowski, J., Young, B., & Jeffcoate, W. J. (2022) · Diabetic Medicine · doi:10.1111/dme.14959 · Cited by 10 · see citing works
Berhane, T., Jeyaraman, K., Hamilton, M., & Falhammar, H. (2022) · ANZ Journal of Surgery · doi:10.1111/ans.17431 · Cited by 8 · see citing works
Fejfarová, V., Pavlů, J., Bém, R., Wosková, V., Dubský, M., Němcová, A., Jirkovská, A., Sixta, B., Sutoris, K., Thieme, F., et al. (2019) · Journal of Diabetes Research · doi:10.1155/2019/5945839 · Cited by 5 · see citing works
Self-citationElbarbary, A. H., Sallam, E. M., & Ismail, A. M. (2020) · The International Journal of Lower Extremity Wounds · doi:10.1177/1534734620971106 · Cited by 4 · see citing works
Flagged first, then by citations
Research works printed but not linked: 3
- Raspovic A, Landorf K. A survey of offloading practices for diabetes- related plantar neuropathic foot ulcers. J Foot Ankle Res. 2014;7(1): 35. https://doi.org/10.1186/s13047-014-0035-8 · DOI · Paper page
- Berhane T, Jeyaraman K, Hamilton M, Falhammar H. Pressure relieving interventions for the management of diabetes-related foot ulcers: a study from the Northern Territory of Australia. ANZ J Surg. 2022;92(4):723-729. https://doi.org/10.1111/ans.17431 · DOI
- Sahu B, Prusty A, Tudu B. Total contact casting versus traditional dressing in diabetic foot ulcers. J Orthop Surg. 2018;26(3): 230949901880248. https://doi.org/10.1177/2309499018802486 · DOI
Cited by
Sorted by citations
Armstrong, D. G., Tan, T.-W., Boulton, A. J. M., & Bus, S. A. (2023) · JAMA · doi:10.1001/jama.2023.10578 · Cited by 1,658 · see citing works
Self-citationSchaper, N. C., van Netten, J. J., Apelqvist, J., Bus, S. A., Fitridge, R., Game, F., Monteiro‐Soares, M., Senneville, E., & the IWGDF Editorial Board (2024) · Diabetes/Metabolism Research and Reviews · doi:10.1002/dmrr.3657 · Cited by 583 · see citing works
Self-citationChen, P., Vilorio, N. C., Dhatariya, K., Jeffcoate, W., Lobmann, R., McIntosh, C., Piaggesi, A., Steinberg, J., Vas, P., Viswanathan, V., et al. (2024) · Diabetes/Metabolism Research and Reviews · doi:10.1002/dmrr.3644 · Cited by 246 · see citing works
12. Retinopathy, Neuropathy, and Foot Care: Standards of Care in Diabetes—2025
American Diabetes Association Professional Practice Committee, ElSayed, N. A., McCoy, R. G., Aleppo, G., Balapattabi, K., Beverly, E. A., Briggs Early, K., Bruemmer, D., Callaghan, B. C., Echouffo-Tcheugui, J. B., et al. (2025) · Diabetes Care · doi:10.2337/dc25-s012 · Cited by 176 · see citing works
van Netten, J. J., Raspovic, A., Lavery, L. A., Monteiro‐Soares, M., Paton, J., Rasmussen, A., Sacco, I. C. N., & Bus, S. A. (2024) · Diabetes/Metabolism Research and Reviews · doi:10.1002/dmrr.3652 · Cited by 89 · see citing works
Lazzarini, P. A., Armstrong, D. G., Crews, R. T., Gooday, C., Jarl, G., Kirketerp‐Moller, K., Viswanathan, V., & Bus, S. A. (2024) · Diabetes/Metabolism Research and Reviews · doi:10.1002/dmrr.3650 · Cited by 57 · see citing works
- Authors
- Bus, S. A., Armstrong, D. G., Crews, R. T., Gooday, C., Jarl, G., Kirketerp‐Moller, K., Viswanathan, V., & Lazzarini, P. A.
- Affiliations
- Amsterdam UMC Location University of Amsterdam (NL)
- University of Southern California (US)
- Rosalind Franklin University of Medicine and Science (US)
- Norfolk and Norwich University Hospital (GB)
- Örebro University (SE)
- Copenhagen Wound Healing Center Bispebjerg University Hospital Copenhagen Denmark
- M.V. Hospital for Diabetes and Diabetes Research Centre (IN)
- Queensland University of Technology (AU)
- Corresponding author
- Bus, Sicco A.
- ORCID
- Venue
- Diabetes/Metabolism Research and Reviews
- Publisher
- Wiley
- Published
- 2023-05-25
- Volume
- 40
- Issue
- 3
- Pages
- e3647-e3647
- ISSN
- 1520-7552 (ISSN-L)
- 1520-7560
- OpenAlex
- W4378173487
- Cited by
- 169
- References
- 55
- Citations by year
- 2026: 68 · 2025: 50 · 2024: 30 · 2023: 17 · 2022: 3 · 2021: 1
- FWCI
- 33.85
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Diabetes/Metabolism Research and Reviews (publishedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- Data Archiving and Networked Services (DANS) (submittedVersion, other-oa)
- Pure Amsterdam UMC (submittedVersion, other-oa)
- Funders
- Novo Nordisk Fonden (NNF16SA0024126-3)
- National Institute of Diabetes and Digestive and Kidney Diseases (R01DK124789)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetic Foot Ulcer Assessment and Management
- Health Sciences › Medicine › Orthopedics and Sports Medicine › Foot and Ankle Surgery
- Health Sciences › Medicine › Rehabilitation › Wound Healing and Treatments
- Keywords
- diabetic foot ulcer, offloading, offloading devices, footwear, Achilles tendon lengthening, metatarsal head resection, metatarsal osteotomy, toe deformity, ulcer healing, amputation prevention
- MeSH terms
- Diabetes Mellitus, Foot, Humans, Ulcer, Wound Healing, Weight-Bearing, Foot Ulcer, Practice Guidelines as Topic, Diabetic Foot, Evidence-Based Medicine
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
