*2.1.2 Offloading*

'Offloading' solutions reduce pressure even more and redistribute weight-bearing load over a bigger region of the foot [15]. The most straightforward method is mandatory bed rest; however, this is ineffective due to poor compliance and the risk of consequences such as osteoporosis as well as deep vein thrombosis. Total contact casting (TCC) is evidence-based offloading as well as the best time-tested approach since it ensures compliance and reduces the bulk and weight of the cast. This relieves ulcer pressure and spreads throughout the foot, which causes wound healing to be faster [6]. This procedure enables the patient to move around while receiving therapy and is effective in reducing edema, which can impede wound healing. Even though difficult and time-consuming, TCC can alleviate the pressure upon that incision, as evidenced by 73–100% healing. The drawbacks of TCC include the need for time as well as skill, the potential for new injuries caused by plaster irritation, the difficulty of daily injury assessment, the increased usage of removable cast walkers, and the lack of daily wound examination, dressing changes, and infection detection. Additional techniques include bed rest, using wheelchairs, walkers, and shoes that are carefully made [22, 23].
