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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

 

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

 

Felt additions alter the geometry at the foot / insole(with felt addition) interface!

 

The use of felt deflective padding in the management of plantar hallux and forefoot ulcers in patients with diabetes abstract

 

Correct and hopefully reduce friction and shear forces at the site of breakdown

 

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.

 

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

 

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

 

on top surface of insole / socklining (always)

 

Goodaye Nick

 

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.

 

LOL, that was good and very true:D

 

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