OBJECTIVE -Pressure mitigation is crucial for the healing of plantar diabetic foot ulcers. We therefore discuss characteristics and considerations associated with the use of offloading devices. RESULTS -Of the 895 respondents who treat diabetic foot ulcers, shoe modifications (41.2%, P Ͻ 0.03) were the most common form of pressure mitigation, whereas total contact casts were used by only 1.7% of the centers. RESEARCH DESIGN AND METHODSCONCLUSIONS -This study reports the usage and characteristics of offloading devices in the care of diabetic foot ulcers in a broadly distributed geographic sample. Less than 2% of specialists use what has been termed the "gold standard" (total contact cast) for treating the majority of diabetic foot ulcers.

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