Offloading difficult wounds and conditions in diabetic patient.

Wounds in the diabetic population represent a significant medical and economic burden. Early recognition and prompt management can facilitate healing of these wounds. The scope of potential interventions includes debridement, infection control, offloading, protective dressings, active dressings (such as growth factors and living skin constructs), revascularization, proper nutrition, and patient education, If foot pressures are to be reduced, healing to progress, and prevention of ulceration to be a realistic goal, offloading is imperative. The following article discusses offloading of difficult wounds and Charcot foot at various stages of treatment. A user-friendly written and pictorial compendium and an algorithm of care are offered, as well as pedorthic management of foot amputations.