Diabetic foot is one of the main complications of diabetes mellitus, defined as the presence of ulcers, infection, or destruction of deep tissues of the feet and even by the loss of sensation affecting feet and legs. Diabetic foot ulcers (DFU) have a significant impact on quality of life, the capacity for walking. Reducing excessive mechanical stress is considered the cornerstone of treatment for neuropathic DFU. called offloading intervention which includes devices and footwears, to redistribute weight on the plantar face. Despite strong evidence support the efficacy of offloading devices, the effectiveness of the intervention depends on adherence from the patient to the treatment, an apparently underexplored subject in the scientific literature. Bibliometric analysis can be used to evaluate publications quantitatively and to predict future research directions.

To identify and analyze current status of scientific production related to diabetic foot ulcer patient's adherence to offloading resources.

A bibliometric analysis of the publications was performed on publications from the main collection of the Web Of Science (WoS) database. The search was carried out in the “topics” field of advanced search, using the terms: cast, offloading, off-loading, offloading device, offloading intervention, non-surgical offloading, ulcer*, diabetic foot, adherence, and patient compliance. We exclude those publications in which adherence was not the dependent variable. The software VOSviewer Copyright © was used to analyze the journals, authors, institutions, countries, and keywords using standard bibliometric indicators. Data were organized in table, graph, and graph format.

The search strategy used resulted in 64 documents that were reduced to 37 after manual analysis. 29 studies were published between the years 2014 and 2022, with the largest number of publications occurring in 2016 (n=6). More cited was “Activity patterns of patients with diabetic foot ulceration – Patients with active ulceration may not adhere to a standard pressure off-loading regimen” authored by David Armstrong, Lawrence Larvey, Heather Kimbriel and Andrew Boulton. The journal Diabetes Care had the highest number of publications. 134 authors have published on the subject of this review. The highest-ranked institution by number of publications was The University of Amsterdam. England, USA and Netherlands were the 3 top ranked countries by citation.

The findings of this study provided information about the trajectory of scientific publications on the subject over the years. The small number of publications on this subject indicates a gap in the scientific literature, providing insight into trends for future studies, considering that adherence directly impacts on the effectiveness of the intervention. In addition, publications found were in English and come from the northern hemisphere, so data from other regions is needed.

We believe that this study can be useful to professionals who are looking to understand the current status of publications on DFU patient's adherence to offloading devices and to point out its relevance as an emerging research subject.