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Reduction of plantar pressure using a prototype pressure-relieving dressing.

It is accepted that pressure relief is among the most important aspects in treating diabetic foot ulcers. Clinically, a variety of off-loading devices are used to redistribute pressure away from the area of ulceration to improve wound healing. The incorporation of pressure-relieving properties in a wound care dressing for the treatment foot ulcers is a new and interesting concept, although currently there is no dressing available that contains specific pressure-relieving qualities.

We therefore aimed to investigate the efficacy of a prototype pressure-relieving dressing (PRD) designed to off-load pressure under individual plantar metatarsal head areas. To establish the pressure-reducing efficacy, the PRD was investigated in patients with intact feet only.

The study had institutional review board approval, and all participants gave informed consent. Eighteen diabetic patients with peripheral neuropathy but without active foot ulceration were recruited from the Manchester Diabetes Centre. Other inclusion criteria were peak plantar pressure >500 kPa and no peripheral vascular disease.

Participants visited the gait laboratory on 3 consecutive days. Dynamic plantar pressures were measured during barefoot walking using the optical pedobarograph (1). Following baseline plantar pressure measurement on day 1, the metatarsal head with the highest plantar pressure was covered with the prototype PRD, after which pressure measurement was repeated. The center of the dressing pad was applied over the bony prominence of the target metatarsal head …