Awareness and Practices Related to the Provision of Offloading Devices for Foot Wounds in Prosthetic and Orthotic Facilities: Orthoses Committee Survey, Part 4

Abstract

 Objective: This study aimed to investigate the current provision of offloading devices for foot wounds by prosthetic and orthotic manufacturing companies in Japan, and to identify barriers, educational needs, and factors facilitating the implementation of offloading treatment.
 Methods: A cross-sectional survey was conducted among prosthetic and orthotic manufacturing companies involved in the provision of offloading devices for foot wounds. Data were analyzed descriptively to examine company characteristics, types of offloading provided, perceived barriers, educational needs, and facilitators of offloading practice.
 Results: Offloading devices were supplied by diverse companies nationwide on the basis of prescriptions issued across multiple medical specialties. Many companies reported their involvement in the provision of custom-made devices. Involvement in non-device-based offloading methods, such as felted foam and total contact casting, was limited. Major barriers included Japanese lifestyle factors, patients’ perceptions and acceptance, and the cost of devices and materials. Educational needs were predominantly centered on device selection and design in accordance with medical prescriptions, highlighting a gap between international guideline recommendations and local clinical practice. Across barriers, educational needs, and facilitators, patients’ understanding and acceptance consistently emerged as key factors.
 Conclusions: These findings provide foundational information from the perspective of prosthetic and orthotic manufacturing companies and insights to facilitate the effective implementation of offloading treatment in Japan.