Current Pedorthics | September-October 2014 | Vol.46, Issue 5 | Page 28

TRANSITIONING FROM OPEN WOUND TO FINAL FOOTWEAR:
OFFLOADING THE DIABETIC FOOT –PART 2

pressure on specific areas of the foot.32,33,34 The key to healing with
any of the off-loading devices is the clinician’s ability to improve
patient adherence by making it impossible to remove the devices
without their approval. Knowles and Boulton,35 found that when
patients were given specialized footwear free of charge, only 20%
of the patients actually wore the shoes. Armstrong, et al.36 found
that when given the ability to remove the devices, RCWs were
worn only 28% of the time during activities of daily living.

Improving the Removable Walker
Removable walkers have been made non-removable by wrapping
the device with cast material, or Coban©, or by applying a
simple cable tie connector to prevent patients from taking off the
devices.1,2 There are also certain dressing techniques that can
be employed to protect the foot with a non-removable dressing
housed within the RCW thereby allowing the patient to remov B