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New techniques of evaluation, risk identification, wound product application, and infection control allow limb preservation to be an extremely viable option for the neuropathic and diabetic population. The orthotist specializing in wound care brings off-loading techniques to the clinical setting to allow immediate reduction of pressure to the wound site. By reducing external forces, the ulceration responds to wound care products efficiently, and closure times decrease with optimal outcomes. Following closure, the foot must be accommodated to prevent further breakdown, and regular patient follow-up should be consistent with their risk identification.