{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T11:11:12Z","timestamp":1790334672824,"version":"4.1.0"},"reference-count":33,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T00:00:00Z","timestamp":1788134400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T00:00:00Z","timestamp":1788134400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["International Wound Journal"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>\n                    Diabetic foot ulcers (DFUs) are difficult to manage in resource\u2010limited settings, where access to standard offloading devices is limited for healing of plantar diabetic foot ulcers. This is due to the cost, limited availability, and the need for specialised expertise.\n                    <jats:italic>Toa Uzito<\/jats:italic>\n                    is a low\u2010cost offloading device developed to address this gap. We evaluated the effectiveness of a low\u2010cost offloading device (\n                    <jats:italic>Toa Uzito<\/jats:italic>\n                    ) in improving healing outcomes in patients with plantar ulcers. A matched case\u2013control clinical study was conducted at a specialised diabetic foot centre in Dar es Salaam, Tanzania. Patients with a single plantar DFU were enrolled. Those treated with\n                    <jats:italic>Toa Uzito<\/jats:italic>\n                    were compared with matched controls who received standard care without offloading. Controls were matched based on age, body mass index, and diabetes duration. The primary outcome was time to complete ulcer healing. Healing were analysed using Kaplan Meier survival analysis and Cox regression. A total of 621 patients were included (128 intervention, 493 controls), with a mean follow\u2010up of 133.8\u2009days. Ulcer healing was significantly better in the intervention group: 44.9% healed (versus 34.9% in controls) by 12 weeks, and increasing to 85% (versus 75.2% in controls) by 24\u2009weeks. All patients in the intervention group healed, with a shorter mean healing time (125.7 vs. 137.5\u2009days).\n                    <jats:italic>Toa Uzito<\/jats:italic>\n                    also demonstrated significantly superior healing efficacy compared with standard care after stratification by SINBAD classification (\u03c7\n                    <jats:sup>2<\/jats:sup>\n                    \u2009=\u200971.2,\n                    <jats:italic>p<\/jats:italic>\n                    \u2009&lt;\u20090.01) . The low\u2010cost\n                    <jats:italic>Toa Uzito<\/jats:italic>\n                    significantly improves healing rates and reduces time to healing. Its affordability and simplicity makes it an effective offloading strategy for promoting DFU healing in resource\u2010limited settings.\n                  <\/jats:p>","DOI":"10.1111\/iwj.71026","type":"journal-article","created":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T07:15:04Z","timestamp":1788160504000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Effectiveness of an Affordable\n                    <scp>\n                      <i>Toa Uzito<\/i>\n                    <\/scp>\n                    Offloading Device for Healing Plantar Diabetic Foot Ulcer: A Matched Case\u2013Control Clinical Study"],"prefix":"10.1111","volume":"23","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4564-0071","authenticated-orcid":false,"given":"Zulfiqarali G.","family":"Abbas","sequence":"first","affiliation":[{"name":"Abbas Medical Centre  Dar es Salaam Tanzania"},{"name":"Muhimbili University of Health and Allied Sciences  Dar es Salaam Tanzania"},{"name":"University of Staffordshire  Stoke\u2010on\u2010Trent UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2998-2883","authenticated-orcid":false,"given":"Roozbeh","family":"Naemi","sequence":"additional","affiliation":[{"name":"School of Health and Society University of Salford  Manchester UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,8,31]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.diabres.2021.109155"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/978-981-15-7639-3_2"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/9781119445821.ch4c"},{"key":"e_1_2_11_5_1","volume-title":"Pocket Guideline of Diabetic Foot","author":"Abbas Z. G.","year":"2019"},{"key":"e_1_2_11_6_1","first-page":"24","volume-title":"Contemporary Management of Diabetic Foot","author":"Abbas Z. G.","year":"2013"},{"key":"e_1_2_11_7_1","unstructured":"International Diabetes Federation \u201cDiabetes Atlas \u201d11th edition 2025 https:\/\/www.diabetesatlas.org\/en\/resources\/."},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2213\u20108587(17)30181\u2010X"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/DMRR.3657"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/DMRR.3687"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra1615439"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.293.2.217"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc09\u20102007"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.2337\/DC09\u20100651"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.1007\/978-981-15-7639-3_14"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.1002\/dmrr.2245"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.diabres.2025.112036"},{"key":"e_1_2_11_18_1","doi-asserted-by":"publisher","DOI":"10.1002\/DMRR.3650"},{"key":"e_1_2_11_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2213\u20108587(16)30012\u20102"},{"key":"e_1_2_11_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1067\u20102516(07)60001\u20105"},{"key":"e_1_2_11_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/J.JVS.2009.05.017"},{"key":"e_1_2_11_22_1","first-page":"695","article-title":"Total Contact Cast for Neuropathic Diabetic Foot Ulcers","volume":"18","author":"Ali R.","year":"2008","journal-title":"Journal of the College of Physicians and Surgeons\u2013Pakistan"},{"key":"e_1_2_11_23_1","first-page":"237","article-title":"A Comparative Study Between Total Contact Casting and Conventional Dressings in the Non\u2010Surgical Management of Diabetic Plantar Foot Ulcers","volume":"106","author":"Ganguly S.","year":"2008","journal-title":"Journal of the Indian Medical Association"},{"key":"e_1_2_11_24_1","doi-asserted-by":"publisher","DOI":"10.2337\/DIACARE.24.6.1019"},{"key":"e_1_2_11_25_1","doi-asserted-by":"publisher","DOI":"10.2337\/DIACARE.28.2.243"},{"key":"e_1_2_11_26_1","doi-asserted-by":"publisher","DOI":"10.1093\/PTJ\/76.3.296"},{"key":"e_1_2_11_27_1","doi-asserted-by":"publisher","DOI":"10.2337\/DC08\u20100771"},{"key":"e_1_2_11_28_1","doi-asserted-by":"publisher","DOI":"10.1111\/J.1524\u2010475X.2010.00571.X"},{"key":"e_1_2_11_29_1","doi-asserted-by":"publisher","DOI":"10.1177\/107110070602700409"},{"issue":"8","key":"e_1_2_11_30_1","first-page":"125","article-title":"Overcoming Barriers to Adopting the Total Contact Cast in Your Practice","volume":"28","author":"Rogers L. 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