The influence of a low-cost offloading intervention (Toa Uzito) on plantar diabetic foot ulcer healing efficacy

This study aimed to investigate the effectiveness of a novel low-cost offloading intervention on the healing efficacy of plantar diabetes foot ulcers (DFU).In intervention group 128(M/F:73/55) cases were treated using the offloading intervention that included a rolled sponge under retainer bandage to protect the wound. The control group included 493(M/F:291/202) patients, who were treated without intervention. Two groups were matched based on age, BMI, and duration of diabetes.The overall healing efficiency in the offloading intervention group was significantly superior with 127/127 followed case patients healed during (Mean ± St.E) 125.7 ± 11.71 days whereas 472/479 followed control patients healed during 137.5 ± 4.9 days. The results stayed significant when adjusted for SINBAD wound classification (χ ²  = 5.651,P = 0.017), ulcer site as Forefoot vs Hind-foot or Mid-foot (χ2 = 4.828,P = 0.028); or ulcer size (χ2 = 4. 566,P = 0.033). Specifically, the healing efficiency was significantly superior in intervention vs control for: SINBAD-4; Non-ischaemic ulcers and for ulcers bigger than 3 cm ² area.The low-cost offloading intervention showed a superior efficacy evidenced through significantly higher proportion of ulcers healing combined with shorter healing duration. These findings indicate the efficacy of the simple to implement and easily adaptable low-cost offloading intervention and its effectiveness in DFU management at the grass root level in LMIC settings.