We treat the ulcer like it’s the disease.
Often, pressure is the disease — the ulcer is the symptom.
In DFU management, you can have:
the best dressing
the best debridement
the best NPWT system
…but without offloading, you’re trying to heal while re-injuring the wound every step.
Critical thinking:
Don’t just document “offloading advised” — ask:
What offloading is the patient actually using day-to-day?
What barriers are real (work, home, cost, mobility, pain)?
What is my next-best option if gold-standard offloading fails?
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