There are a number of health risks associated with diabetes including cardiovascular disease, neuropathy (nerve damage), infection, retinopathy, delayed healing, liver and kidney disease, and the increased potential in developing serious foot and leg complications such as a Diabetic Foot Ulcer (DFU) – which can lead to amputation if not managed quickly and properly.
A Diabetic Foot Ulcer is an open sore or wound commonly found on the bottom of a person’s foot that occurs in 15% of diabetics. Having an open wound or sore on a diabetic foot creates a portal of entry for bacteria to enter the body, which could lead to serious infection, such as cellulitis and osteomyelitis.
According to the American Podiatric Medical Association, 14-24% of patients with diabetes who develop a foot ulcer will require an amputation, and about 75% of those who do get an amputation will pass away within the next 5 years. Even though this may sound alarming, 85% of these amputations are preventable!
There are various types of diabetic foot and leg ulcers such as arterial ulcers, venous ulcers, neuropathic ulcers, pressure ulcers, and ischemic ulcers. As a result, a person living with Diabetes and an active foot ulcer requires a multi-disciplinary approach to their care using their family doctor, endocrinologist, vascular surgeon, neurologist, orthopedic surgeon, infectious diseases specialist, Pedorthist, and their Podiatrist to help identify, treat, manage, and heal their wounds.
Proper Wound Care Consists Of:
- Identifying the type of diabetic foot ulcer
- Offloading the wound site
- Sharp debridement of the wound edges and unwanted tissue
- Applying the appropriate wound dressings
- Addressing any factors or causes such as:
- Improper fitted shoes
- Poor circulation
- Skin pathologies (callous, blisters, corns)
- Bony prominences (bunions, hammer toes)
- Improper biomechanics
- Good glycemic control is also very important
Offloading a Diabetic Ulcer is a key component to healing a wound on the diabetic foot because each step that a patient takes on the wound does not allow the wound edges to close and heal properly, which can lead to further tissue breakdown and possible infection.
Devices Used To Offload a Diabetic Foot Ulcer Are:
- Total Contact Casts
- Boot Walkers
- Custom Orthotics
- Padding and Strapping by a Podiatrist
- Post-operative Surgical Footwear
The BREG – BLEDSOE Diabetic Conformer Boot Walker is a newly designed boot walker made specifically to treat ulcerations and pre-ulcerations on a diabetic foot. Boot walkers are a general offloading device with many applications such as treating stress fractures, sprained ankles, surgical procedures, and other foot conditions. What makes the BREG – BLEDSOE Diabetic Conformer Boot Walker different and unique from the traditional boot walkers is that it features an Auto–mold™ Dual Density foam footbed. This material is similar to a memory foam pillow, and it is designed to evenly distribute body weight across the entire bottom surface of the foot, and it molds to the patient’s foot to help prevent any movement that could break down skin. The material is breathable, won’t absorb fluids from a draining ulcer, and is easy to clean. The boot also features a fully enclosed foam cocoon to maximize protection of the leg and foot, as well as an inflatable ankle air bladder to help create a better fit and prevent unwanted motion inside the boot itself.
Traditionally, a total contact cast was the gold-standard to offloading a diabetic foot ulcer for the past few decades.
Until recently, studies show the BREG – BLEDSOE Diabetic Conformer Boot Walker distributes plantar pressure to the sides of the foot thereby reducing peak pressure on the bottom by 30%, on average, compared to a Total Contact Cast.
This would drastically reduce healing time and therefore would decrease chances of infection and possible amputation. As a Podiatrist, I use evidence-based research to implement the best treatment plan and protocols for my diabetic patients.
If you are diabetic or if you know of any diabetic patients with ulcerations or pre-ulcerations, the BREG – BLEDSOE Diabetic Conformer Boot Walker is a product that we highly recommend.
Dr. Jason Ju, BHSc, D.CH, Podiatrist
Arthritis & Injury Care Centre