Emerging Orthoses May Provide Improved Offloading Of Wounds

An innovative line of orthoses appears to be successful in promoting wound healing among patients with diabetic wounds.

The Orthomerica Whole Limb Solutions (OWLS) program was developed with the goal of keeping patients ambulatory while simultaneously supporting the foot and ankle to promote wound healing, notes the manufacturer Orthomerica. Diabetic ulcers, which are common in patients who have an orthopedic anomaly and/or a neuropathic foot, present a significant treatment challenge, which the OWLS line of orthoses may help address.

The latest addition to the OWLS group of orthoses is the Carbon Laminate Alignment Walker or CLAW™. According to the company, the CLAW provides a triplanar alignment tool that increases stability while standing and also provides a smooth heel compression and dynamic rocker action while patients are walking.

The original OWLS concept was developed in part by Larry Suecof, DPM, FACFAS, CWS. Dr. Suecof, who has 30 years of experience running a wound center and is affiliated with the Orlando Foot and Ankle Clinic, describes several features of the OWLS devices that are unique in the marketplace.  

“When talking about ambulating wounds on the foot, there’s really no other product that gives full offload to the ball of the foot or the heel while giving patients the stability to ambulate,” says Dr. Suecof.

Describing the CLAW, which was developed for the treatment of midfoot ulcers, Dr. Suecof says the product is capable of dialing out almost all of the pressure that is borne by ulcers under the center of the foot. One can achieve this by manipulating a variety of gait parameters and geometric parameters relevant to the wound, he notes.

The CLAW allows for progressive adjustments to accommodate variables of a patient’s gait. These adjustments provide the patient with a more normal and fluid gait, encouraging more walking activities, notes the manufacturer.

John Presley, MD, says the customization and adjustability of the OWLS orthoses are qualities that he finds appealing. He also cites the ability to use the product in patients with osteomyelitis as a key benefit.

Dr. Presley recalls one patient who had a 33-year-old injury due to oil field boots. The patient, who had been in a wound center for about 18 years, had ulcers over Achilles tendons in both legs that had failed to heal due to movement of the tendons, which resulted in the skin grafts breaking down.

“[The patient] was placed in OWLS boots and since then, the wounds have steadily progressed. He has had a truly remarkable turnaround,” says Dr. Presley, who is affiliated with Christus Good Shepherd Health System in Longview, Texas.

“Many doctors use standard ankle-foot orthoses (AFOs) as part of their treatment protocol for treating pressure ulcers on the bottom of the foot and it does speed up healing relative to just wearing a surgical shoe,” notes Dr. Suecof. “But very few people actually heal in them because they don’t really offload the wound. They just don’t do the job that you really want them to do.”

The OWLS devices, on the other hand, “really click all of the boxes for someone who is looking to heal a wound,” says Dr. Suecof.