When we brought the PRAFO ankle foot orthosis to the UK in the 1990’s, heel pressure sores and diabetic foot ulcers were a huge problem for the NHS. Actually they are still a massive problem for the NHS. A major key to prevention is to relieve or ideally eliminate pressure and shear effects. The biomechanics of tissue are complex and this means that it is easier to aim to eliminate pressure and shear rather than use a method which assumes that a particular level of pressure is “safe”. The reason the PRAFO range is so effective for prevention and treatment of heel ulcers is that it cradles and positions the foot and ankle so that there is no possibility of pressure or shear force at the heel.

For decades now pressure sores have been recognised as a serious yet preventable world-wide problem.  Here we are in 2017 and we still are not doing enough to prevent these even though we know who is at risk and we know what factors elevate the risk.  In Scotland, the Diabetic Foot Action Group has been working hard to both raise the quality of care and consistency across Scotland.  As we described in our last article on CPR for the Diabetic Foot, a Scottish system audit identified potential savings of £15 million per year if even 75% of diabetic foot ulcers could be prevented. 

The NHS in Scotland could save £15m a year by implementing "CPR" for the diabetic foot. An audit organised by the Scottish Foot Action Group has shown the potential impact of taking the prevention of hospital-acquired diabetic foot ulcers seriously. By checking patients feet on admission, protecting the foot if at risk and referring for treatment if necessary. So often pressure relief devices like the PRAFO are looked on as a "cost" when this study clearly shows that using these devices can produce a massive saving both in money and distress when used thoughtfully and appropriately.

The costs of dealing with pressure and diabetic foot ulcers are staggering. Pressure relief orthotic interventions should be more widely understood and used.  We started Anatomical Concepts more than 20 years ago after I saw a great product (The PRAFO Ankle Foot Orthosis) which we still deal with today.  It's not quite as "sexy" as some of the products we deal with, but in terms of it's clinical signficance and impact it is by far the best product range we have.