Summary of recommendations of guidelines for the offloading of diabetic foot ulcer

Abstract

Objective To retrieve and analyze the guidelines on diabetic foot offloading, and summarize the evidence of high quality guidelines, so as to provide reference for standardizing the offloading treatment of diabetic foot in China. Methods The clinical practice guidelines of diabetic foot in the major guideline networks, databases and professional association websites were retrieved by computer. Three researches evaluated the quality of the guidelines, and two researches extracted evidence from documents that met the quality criteria. Results A total of 7 guidelines were included, and 5 aspects, 30 recommendations were extracted, including comprehensive treatment, the principle of offloading, offloading of the plantar ulcer, offloading of the non-plantar ulcer, and the gap between the evidence and practice. Conclusions This study summarize the best evidence of the diabetic foot offloading therapy, and provides a reference for medical institution to develop appropriate procedures and standardize the practice of diabetic foot offloading therapy. Most of the interventions recommended in the guidelines come from relatively developed countries, but their application may be limited in less developed countries or regions. Therefore, it is urgent to explore offloading methods which have positive offloading effect as well as conform to our national conditions, and apply them to clinical practice gradually in order to improve the therapeutic effect of diabetic foot and improve prognosis. Key words: Diabetic foot; Guideline; Evidence summary; Offloading therapy; Evidence-based nursing; Recommendations