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Felt to offload ulcers

Discussion in 'Diabetic Foot & Wound Management' started by cwiebelt, Feb 23, 2011.

  1. cwiebelt

    cwiebelt Active Member


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    I have a question re: felting to off load plantar foot ulcers, which is becoming more commonly used.
    does anyone have any evidence re its effectiveness? guidelines as to the use of felting.
    how long can felt be applied to off load the foot>
    appreciate any info

    Chris
     
  2. Catfoot

    Catfoot Well-Known Member

    Hi cwiebelt,
    I don't know of any studies that specifically describe the effectiveness of felt for offloading but I do have plenty of empirical examples.
    In my experience felt is often a good first choice for offloading and uncomplicated plantar ulcers should heal with 6/8 weeks using this medium.

    Where there are other factors involved, such as a poor blood supply, infection or an ulcer producing copious exudate felting should not necessarily be the first choice and other methods should be considered. Each case should really be assesed on its own merits.

    regards

    Catfoot
     
  3. markjohconley

    markjohconley Well-Known Member

    Felt additions alter the geometry at the foot / insole(with felt addition) interface!
     
  4. Correct and hopefully reduce friction and shear forces at the site of breakdown
     
  5. cwiebelt

    cwiebelt Active Member

    yes i agree with the comments made
    I believe applying felt is a short term measure 6-8 weeks (as mentioned by catffoot thanks by the way) to provide inital off loading to heal a ulcer.
    Or at least until a more deffinitive off loading device can be made and foot wear review.

    i just have some concerns with the long tem use of felt on the foot.
     
  6. Boots n all

    Boots n all Well-Known Member

    l too l have concerns with long term use.

    It gets dirty and if the ulcer has wept on it it can harden and it is not something you can clean....looks quite gross after a while and often smells bad, not popular with the clients
     
  7. flipper

    flipper Member

    Are you guys/girls using felt applied to the insole/shoe or applying to the patient with a hole cut out for offloading?
    I changed places of work and saw that some people were using felt applied to the patient with a cutout for off loading ( met head padding and 2nd cutout) once the dressing was put on. I found that this could cause a fair bit of irritation to the patients skin but worked reasonably well for the offloading. Less irritation if the mefix (dressing tape) was put on as protection but that just meant they left it on for longer!
    Try to stand clear of that now but some patients swear by it.

    Cheers
    Nick
     
  8. markjohconley

    markjohconley Well-Known Member

    on top surface of insole / socklining (always)
     
  9. markjohconley

    markjohconley Well-Known Member

    Goodaye Nick
     
  10. cperrin

    cperrin Active Member

    We use felt to good effect where i work when treating ulcerations - however have seen places where its use is pointless i.e. people offloading using only 3, 5 or 7mm SCF, and then they wonder why its flat as a pancake when the patient who is usually the size of a wrecking ball returns.
     
  11. Boots n all

    Boots n all Well-Known Member

    LOL, that was good and very true:D
     
  12. markjohconley

    markjohconley Well-Known Member

    Even a 1mm (compressed 3mm) addition changes forces (location, direction, magnitude).
     
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