B06: Pressure Offloading & Load Distribution

The IWGDF describes offloading as arguably the most important intervention for healing a diabetic foot ulcer. Dressings, antibiotics and biologics act on the wound, but none of them stops the patient walking on it. Yet the total contact cast, the device every other is measured against, is used in only a minority of eligible patients, so the intervention with the strongest healing signal is the one least often delivered.

The module teaches the biomechanics of pressure, time and shear, and why the neuropathic foot loads badly. It sets out the hierarchy: non-removable knee-high device first, removable second, footwear with felt third, with device height and rigidity matched to ulcer location. It covers the evidence for non-removable over removable devices, adherence and standing as hidden doses, contraindications such as spreading or deep infection and moderate-to-severe ischaemia, safe application and early cast review, transfer lesions, and decisions for heel, non-plantar, infected or ischaemic wounds.

Content is tiered at Foundation, Core and Advanced level, with two decision algorithms and case vignettes. You receive the Teaching Document, the Evidence Base, the slide deck, a narrated video and an audio overview.