DOI: http://dx.doi.org/10.18203/2349-2902.isj20173417

Offloading of diabetic foot wounds using Amit Jain’s offloading system: an experience of 23 cases

Roshan Dath, U. Venkatkrishna Rao, Kishore Kumar, Harish Kumar, Suresh Kumar

Abstract


Background: It is a well-known fact that around 15% of patients with diabetes are likely to be affected by foot ulcers during their lifetime. The aim of this study was to evaluate and analyze Amit Jain’s offloading system used in diabetic foot wounds.

Methods: A cross-sectional, retrospective study was done at 3 centres namely Brindhavvan Areion Hospital, Synergy Centre for Diabetes and South City hospital in Bangalore, India. The study period was for 1 year from April 2016 to March 2017.

Results: 23 cases were included in the study. 16 patients (69.57%) had right foot involved whereas 7 patients (30.43%) had left foot involved. Majority of the patients had foot problems located at forefoot (86.96%). The most common condition where Amit Jain’s offloading was used was in trophic ulcer (61%). In 22 patients (95.65%), the microcellular rubber and ethyl vinyl acetate combination was used whereas in one patient (4.35%), 7 mm of single layered EVA was used. 9 patients (39.13%) had their wounds healed within 8 weeks whereas 11 patients (47.83%) had their wounds healed within 8-16 weeks.

Conclusions: Amit Jain’s offloading device is a new offloading device that can be effectively used as an alternative to felted foam. It is based on deflective technique just like felted foam. In this series, 86.98% of the wounds had healed by 16 weeks with this new offloading device. The Amit Jain’s offloading device, which has a scientific rationale based on the deflective offloading as well as usage of visco-elastic material that is accepted worldwide, produces effective wound healing without any complication and without inhibiting patient’s mobility. Amit Jain’s offloading is a level one recommendation for diabetic foot wounds.


Keywords


Amit Jain, Diabetic foot, Felt, Law, Offloading, Ulcer

Full Text:

PDF

References


Ahmed AA. Diabetic foot: Offloading Devices. MEJFM. 2009;7(6):18-21.

Foley L. Pressure point offloading in the diabetic foot. Primary Intention. 1999;102-108.

Deursen RV. Mechanical offloading and offloading of the plantar surface of the diabetic foot. CID 2004;39:589-91.

Armstrong DG, Lavery LA, Nixon BP, Boulton AJ. It’s not what you put on, but what you take off: techniques for debriding and offloading the diabetic foot wound. CID. 2004;29:592-99.

Raspovic A, Landorf KB. A survey of offloading practices for diabetes related plantar neuropathic foot ulcers. J Foot Ank Resear. 2014;7:35.

Shankhdhar K, Shankhdhar LK, Shankhdhar U, Shankhdhar S. A case report: offloading the diabetic foot wound in the developing world. J Diab Foot Comp. 2011;3(2):26-29.

Cavanagh PR, Bus SA. Offloading the diabetic foot for ulcer prevention and healing. J Am Podiatr Med Assoc. 2010;100(5):360-8.

Agrawal VP, Sreeramulu PN. Most easy on the pocket offloading device costing <1 $ for rural diabetic foot ulcers. Surgery Curr Res. 2012;2:4.

Jain AKC. Amit Jain’s offloading system for diabetic foot wounds: a better and superior alternative felted foam. IJMSCI. 2017;4(1):2604-9.

Wu SC, Jensen JL, Weber AK, Robinson DE, Armstrong DG. Use of pressure offloading devices in diabetic foot ulcers. Diabetes Care. 2008;31(11):2118-9.

Mulder G, Alfieri D. The diabetic foot: consideration for pressure reduction and offloading. Primary Intention. 2007;15(2):58-65.

Curran MJ, Ratcliffe Connor, Campbell J. A comparison of types and thickness of adhesive felt padding in the reduction of peak plantar pressure of the foot: a case report. J Med Case Reports. 2015;9:203.

Sambrook E, Delpierre T, Bowen G. Advancing the gold standard in offloading the diabetic foot. Wounds UK. 2015:48-26.

Wu S. Pressure mitigation for the Diabetic foot ulcer. Podiatry Management. 2015:79-85.

Cavanagh PR, Bus SA. Offloading the diabetic foot for ulcer prevention and healing. J Vas Surg. 2010;52(3):375-435.

Nubé VL, Molyneaux L, Bolton T, Clingan T, Palmer E, Yue DK. The use of felt deflective padding in the management of plantar hallux and forefoot ulcers in patients with diabetes. The Foot. 2006;16(1):38-43.

Zimny S, Reincsh B, Schatz H, Pfohl M. Effect of felted foam on plantar pressures in the treatment of neuropathic diabetic foot ulcers. Diabetes Care. 2001;24(12):2153-4.

Jain AKC. Amit Jain’s classifications for offloading the diabetic Foot wounds. IJMSCI 2017;4(5):2922-5.