UNASSIGNED: Footwear and offloading techniques are commonly used in clinical practice for preventing and healing of foot ulcers in @entity1 with @entity6 . The goal of this systematic review is to assess the medical scientific literature on this topic to better inform clinical practice about effective treatment. We searched the medical scientific literature indexed in PubMed, EMBASE, CINAHL, and the Cochrane database for original research studies published since May 1st 2006 related to four groups of interventions: 1) casting; 2) footwear; 3) surgical offloading; and, 4) other offloading interventions. Primary outcomes were @entity1066 prevention, @entity1066 , and pressure reduction. We reviewed both controlled and non-controlled studies. Controlled studies were assessed for methodological quality, and extracted key data was presented in evidence and risk of bias tables. Uncontrolled studies were assessed and summarized on a narrative basis. Outcomes are presented and discussed in conjunction with data from our previous systematic review covering the literature from before May 1(st) 2006. We included two systematic reviews and meta-analyses, 32 randomized controlled trials, 15 other controlled studies, and another 127 non-controlled studies. Several randomized controlled trials with low risk of bias show the efficacy of therapeutic footwear that demonstrates to @entity551 and is worn by the @entity1 , in the prevention of plantar foot @entity1066 recurrence. Two meta-analyses show non-removable offloading to be more effective than removable offloading for @entity1411 . Due to the limited number of controlled studies, clear evidence on the efficacy of surgical offloading and felted foam is not yet available. Interestingly, surgical offloading seems more effective in preventing than in healing ulcers. A number of controlled and uncontrolled studies show that plantar pressure can be reduced by several conservative and surgical approaches. Sufficient evidence of good quality supports the use of non-removable offloading to @entity1411 and therapeutic footwear with demonstrated pressure relief that is worn by the @entity1 to prevent plantar foot @entity1066 recurrence. The evidence base to support the use of other offloading interventions is still limited and of variable quality. The evidence for the use of interventions to prevent a first foot @entity1066 or heal ischemic, infected, non-plantar, or proximal foot ulcers is practically non-existent. High-quality controlled studies are needed in these areas. This article is protected by copyright. All rights reserved.

Footwear and offloading interventions to prevent and heal foot ulcers and @entity551 in @entity1 with XXXX : a systematic review.

@entity1 :: ('9606', 'Species') :: ['patient', 'persons'] @entity6 :: ('MESH:D003920', 'Disease') :: ['diabetes'] @entity1066 :: ('MESH:D014456', 'Disease') :: ['ulcer', 'ulcer healing'] @entity1411 :: ('MESH:D016523', 'Disease') :: ['healing plantar neuropathic forefoot ulcers', 'heal plantar neuropathic forefoot ulcers'] @entity551 :: ('MESH:D007022', 'Disease') :: ['relief plantar pressure']
@entity6 :: (MESH:D003920,Disease) :: ['diabetes']
