CoChat
Sign Up
Cited by 118Diabetic Foot Ulcer Assessment and ManagementFoot and Ankle SurgeryWound Healing and Treatments

The DOI matches its Crossref record; 59 of the 60 references it cites were found in a registry or an index.

The role of pressure offloading on diabetic foot ulcer healing and prevention of recurrence.

Open access
Bus, Sicco A.·2016·Plastic & Reconstructive Surgery
DOI 10.1097/prs.0000000000002686
Open this paper in CoChat — free account

Abstract

BACKGROUND: An increased plantar pressure is a causative factor in the development of plantar foot ulcers in people with diabetes mellitus, and ulcers are a precursor of lower extremity amputation. METHODS: In this article, the evidence is reviewed that relieving areas of increased plantar pressure (ie, offloading) can heal plantar foot ulcers and prevent their recurrence. RESULTS: Noninfected, nonischemic neuropathic plantar forefoot ulcers should heal in 6 to 8 weeks with adequate offloading. Recent meta-analyses and systematic reviews show that nonremovable knee-high devices are most effective. This is probably because they eliminate the problem of nonadherence with the use of a removable device. Studies show a large discrepancy between evidence-based recommendations on offloading and what is used in clinical practice. Many clinics continue to use methods that are less effective or have not been proven to be effective, while ignoring evidence-based methods. Strategies are proposed to address this issue, notably the adoption and implementation of recent international guidelines by professional societies and a stronger focus of clinicians on expedited healing. For the prevention of plantar foot ulcer recurrence in high-risk patients, 2 recent trials have shown that the incidence of recurrence can be significantly reduced with custom-made footwear that has a demonstrated pressure-relieving effect through guidance by plantar pressure measurements, under the condition that the footwear is worn. CONCLUSION: This review helps to inform clinicians about effective offloading treatment for healing plantar foot ulcers and preventing their recurrence.

Overview

Integrity signals

Registry

Crossref · 10.1097/prs.0000000000002686

Cites

59 of 59 references verified0 citation errors · 0 not checkable

Statistics

Recomputing p-values needs the paper’s full text.

Verification

Claims the paper makes

The text we found for this paper looks like another document, so its claims and self-check weren’t run. The registry and citation checks still apply.

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

The text we found for this paper looks like another document, so the self-check wasn’t run.

Citations

Cites

Show all 60 references

Cited by

Sorted by citations

Items 101–118 of 118

Related

See all

Metadata

Authors
Bus, S. A.
Affiliations
Amsterdam UMC Location University of Amsterdam (NL)
Corresponding author
Bus, Sicco A.
ORCID
Bus, Sicco A.
Venue
Plastic & Reconstructive Surgery
Publisher
Ovid Technologies (Wolters Kluwer Health)
Published
2016-09
Volume
138
Issue
3S
Pages
179S-187S
ISSN
0032-1052 (ISSN-L)
DOI
10.1097/prs.0000000000002686
OpenAlex
W2512750658
Cited by
118
References
60
Citations by year
2026: 2 · 2025: 9 · 2024: 18 · 2023: 20 · 2022: 24 · 2021: 13 · 2020: 11 · 2019: 8 · 2018: 7 · 2017: 5 · 2016: 1
FWCI
1.03
Type
journal article
Language
en
Open access
Licence
other-oa
Locations
  • Plastic & Reconstructive Surgery (publishedVersion)
  • PubMed (publishedVersion)
  • Data Archiving and Networked Services (DANS) (submittedVersion)
  • Pure Amsterdam UMC (submittedVersion, other-oa)
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 › Surgery › Wound Healing and Treatments
Keywords
diabetic foot ulcer, pressure offloading, plantar pressure, ulcer healing, ulcer recurrence prevention, plantar pressure measurement, diabetic neuropathy, lower extremity amputation prevention, evidence-based practice
MeSH terms
Foot, Humans, Pressure, Recurrence, Wound Healing, Weight-Bearing, Treatment Outcome, Diabetic Foot, Secondary Prevention, Foot Orthoses

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