Foot pressure analysis clinic; A multidisciplinary diabetic foot clinic service development
The complex aetiology of diabetic foot ulceration is reflected by the multifaceted management approach necessary for successful wound resolution. Reducing plantar pressures are one crucial aspect of optimising healing potential and preventing re-ulceration, particularly in neuropathic feet absent of protective sensation, where plantar loads and tissue stress are increased. Thus, insoles designed to reduce elevated plantar pressure are prescribed to prevent diabetic foot ulceration recurrence. Yet their effectiveness is difficult to predict and often evaluated using the high risk strategy of observing foot health or deterioration over time.
The pressure analysis assessment service is for patients attending the multidisciplinary diabetic foot clinic Derriford Hospital who might benefit from 1) the immediate evaluation of insole effectiveness, 2) insole modifications to optimise plantar pressure reduction, 3) the appropriate provision of temporary offloading interventions.
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The service extends and complements the existing expertise offered to patients attending the multidisciplinary diabetic foot clinic at Derriford Hospital Plymouth. This rehabilitation service is aimed primarily at high risk patients transitioning from offloading devices for ulcer treatment to footwear and insoles for ulcer prevention. The pressure analysis evaluation uses F-scan in-shoe pressure analysis technology.
The aim of this service is to optimise effectiveness and reduce outcome variability of protective footwear and insoles provided to patients at risk of re-ulceration.