Treating Lower Extremity Wounds In The Face Of Systemic Disease

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Treating Lower Extremity Wounds In The Face Of Systemic Disease
The clinical appearance of this erythematous nodule is highly characteristic of a melanoma with a large central nodule, possibly arising within a congenital nevus. (Photo courtesy of James Q. Del Rosso, DO, FAOCD)
Clinical Editor: Lawrence Karlock, DPM

   Drs. Karlock and Schlanger also cite nicotine abuse. Smoking, alcohol and drug abuse all inhibit the body’s healing ability due to hypoxia and vasoconstriction or malnutrition and liver damage, according to Dr. Schlanger. He adds that steroids and chemotherapy are cytotoxic and can disrupt healing.

   Dr. Miller also adds inadequate perfusion and metabolic abnormalities to the list of factors that negatively affect wound healing. However, he notes such factors are “virtually endless” and include the systemic effects of bodily systems, including hepatic and renal systems. “Suffice it to say that you need to search for not just the cause of a chronic wound but related healing-inhibitory factors,” notes Dr. Miller.

Dr. Miller is certified in chronic wound management and board certified in general surgery. He is the Medical Director of four wound healing centers in Indiana.

Dr. Schlanger is the Director of the Ohio State University Wound Healing Center at University Hospital East. He is a Fellow of the American College of Surgery.

Dr. Karlock is a Fellow of the American College of Foot and Ankle Surgeons, and practices in Austintown, Ohio. He is a member of the Editorial Advisory Board for WOUNDS, a Compendium of Clinical Research and Practice.

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