Simple, creative devices in the management of plantar foot injury

Dear Editors, Plantar foot injuries are quite common, whether acute or chronic, neuropathic or peripheral, vascular disease related, traumatic, or postoperative wounds. According to the physiology of the foot, it supports the weight of the entire body, and bears the friction and high pressure resulting from daily activities. Therefore, a wound located at the plantar foot is difficult to care for and also affects the quality of life of the patient. In plantar foot injuries, complicated wound dressing most often provided insufficient protection and resulted in poor hygiene due to gauzes easily falling off on contact with the patient’s shoes or slippers. Weight-bearing pressure on the plantar is one of the most important factors that affect wound healing in the plantar foot. Deterioration of reduced blood flow, aggravation of the localized tissue ischemia injury and tissue destruction due to continued and repetitive synergistic effect of shear forces, friction and tension from daily ambulation worsen the wound healing process(1). These wounds frequently become infected, cause great morbidity, engender considerable financial costs and may usually incite lower extremity amputation in worst circumstances (2). Thus, offloading the overly pressured forefoot can be considerably crucial in managing plantar wounds. A simple idea is to modify a slipper into a pressure-diversion device. The base of a slipper was scooped out correspondingly to match the location and size of the plantar wound (Figure 1). The patient would therefore be able to walk with the modified slipper as less pressure was applied to the wound area (Figure 2). Adequate perfusion and pressure alleviation are the fundamental principles in the treatment of plantar foot injury. The base of the footwear must be excavated according to the size and