The effectiveness of felt padding for offloading diabetes-related foot ulcers, at baseline and after one week of wear

Kate Waller1,  Anita Raspovic2, Wan Mun Wong2

1Northern Health, Melbourne, Australia

2Discipline of Podiatry and La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, La Trobe University, College of Science, Health and Engineering, La Trobe University, Bundoora, Melbourne, Australia, 3086

Aim: Felt padding is used to offload diabetes-related foot ulceration although limited quality data exists to support its use. This study aimed to quantify pressure offloading from neuropathic plantar foot ulcers in a clinical setting, when felt padding is first applied and after wear.

Methods: This study used a within-subjects, repeated measures design. Data was collected in a high-risk foot service. Peak plantar pressures, contact area and contact time were measured in 15 diabetes subjects with 16 non-complicated plantar neuropathic foot ulcers, with: no felt padding, newly applied felt padding and felt padding after one week of wear.

Results: Statistically significant decreases in peak pressure of 49% and 32% were measured with newly applied felt padding (188.0kPa; p<0.001) and worn felt padding (248kPa; p=0.003) respectively, compared to no padding (367.2kPa). Worn felt offloaded 32% less pressure than new felt however this did not reach statistical significance (p=.069).

Conclusion: New felt padding offloaded on average ½ the pressure applied to sites of plantar neuropathic ulceration, which reduced to 1/3 after wear. Further studies are required to evaluate effectiveness of felt padding directly on ulcer healing.

Significance of the findings to allied health: Felt offloading for plantar neuropathic ulcers is a very important and integral part of wound management. With frequent patient reviews for replacement of this felt, this shows podiatrists, wound care specialist and patients that this reduces up to half the pressure directly on the wound to allow for wound healing.