The Effectiveness of Three Layers Foam Dressing as an Offloading Technique in Treating Diabetic Foot Ulcer : Comparative Study

Abstract

Background and aim of the work: and aim of the work: More than 25% of Saudi Arabia population are diabetics, about 20% of the will develop ulcer in their feet. Offloading is the cornerstone in prevention or healing of plantar neuropathic foot ulcers. This study aimed to investigate the effectiveness of use of three layers elastic foam as an off-loading modality in patients with diabetic non infected neuropathic ulcers in term of the speed of healing progress and comparing that with removable walking boat off-loading techniques. Patients and methods: this prospective double-blind, randomized, controlled clinical trialwas done in diabetic foot care clinics at King Abdul Aziz specialist Hospital, King Faisal general Hospital and Prince Mansour military Hospital, Taif, Saudi Arabia from January 2014 to October 2016.Diabetic patients with non infected neuropathic plantar ulcers after debridement of at least 2 weeks were included in the study. Ischemic ulcers are excluded from the study. Patients who met the inclusion criteria of this study weresubdevided randomized into 2 groups, the felted foam dressings group; in which the three layers felted foam was applied around the ulcer. Control group the removable walking boat was used. In both groups the ulcer was covered with saline soaked dressing to be changed daily. Results:47 patients were enrolled in the study (23 in felted foam group and 24 in the removable walking boat group). There was no significant difference in the demographics, ulcer size, duration of diabetes, and clinical and laboratory data between both groups (P > 0.05). The mean duration of complete healing of the ulcer was highly significantly shorter in felted foam group than in the removable walking boat group (P < 0.001). In both groups the duration of healing was negatively correlated with the patient age, the level of HbA1c,andthe ulcer size (P < 0.05). Conclusions: the three layers felted foam is effective, simple, and less expensive offloading technique and it superior to removable walking boat in promoting the complete healing of neuropathic diabetic foot ulcers.