Concepts of external relief-Offloading foot lesions at a diabetic foot treatment unit

Background: Diabetic foot complications are burdensome for patients and society and a therapeutic challenge even for specialized healthcare professionals. Objective: Principles and overview of external offloading techniques. Material and methods: Overview of recent guidelines and the literature. Results: Loss of protective sensation (LOPS) caused by neuropathy is the key to the etiology of diabetic foot lesions. Disturbance of arterial perfusion and foot deformities can further complicate the issue. Local offloading techniques, e.g., total contact casts and cushioning materials, are essential to reduce local pressure and shear forces. Conclusion: A multitude of possible causes can induce diabetic foot lesions and all triggers must be addressed in the treatment. Only interdisciplinary teamwork between various disciplines and professional groups as well as treatment levels can guarantee a sufficient quality in the treatment of those affected.