Diabetic Foot Ulcers: Offloading, Surgery, and Beyond



Diabetic Foot Ulcers: Offloading, Surgery, and Beyond

Summary: At SAWC Spring 2026, Drs. Paul Kim and Johanna-Marie Richey stressed that successful DFU management requires correcting biomechanical abnormalities rather than focusing solely on wound closure. The session covered comprehensive assessment (perfusion, infection, biomechanics), non-operative offloading strategies, and selective surgical interventions (e.g., flexor tenotomy, metatarsal osteotomy, Achilles lengthening) to reduce recurrence and preserve function.

Key Highlights:

  • Biomechanical evaluation and weight-bearing imaging are essential
  • Prioritize adequate offloading before considering surgery
  • Surgery should target specific mechanical deformities
  • Goal is durable healing with a functional, stable residual foot

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Keywords: DFU offloading, diabetic foot surgery, biomechanical DFU