The Top Ten Innovations In Podiatric Care
- Volume 21 - Issue 8 - August 2008
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In the annual roundup of emerging advances in podiatry, this author talks to podiatrists to get their thoughts about new surgical devices, vascular assessment tools and intriguing diagnostic innovations.
Advances in technology have the potential to reshape and redefine commonly held thought processes and practices in podiatry. This year’s list includes a quicker option for assessing microvascular flow, an ankle arthrodesis locking plate and a diagnostic device that may facilitate earlier recognition of lower extremity melanomas.
With that said, let us take a closer look at 10 emerging innovations.
Getting A Clearer View Of The Microvascular Picture
1) OxyVu-1 (HyperMed). While the ankle-brachial index (ABI), toe-brachial index (TBI) and angiograms have proven useful in helping to assess macrovascular issues in patients with diabetes, mainstream diagnostic tools to ascertain microvascular flow were limited to measuring transcutaneous partial pressure of oxygen (TcPO2), notes Lee Rogers, DPM, the Director of the Amputation Prevention Center at Broadlawns Medical Center in Des Moines, Iowa.
However, Dr. Rogers says the emergence of the OxyVu-1 system brings another option to the table. He notes this modality employs hyperspectral imaging that enables physicians to see beyond the visible spectrum to detect oxygenated hemoglobin subcutaneously.
The camera system with OxyVu-1 creates an image of hemoglobin oxygenation status with 100-micron resolution, notes HyperMed. The company says the device combines spectral and spatial views to convey information about tissue structure and function, as well as subclinical information that the naked eye cannot see. HyperMed says the product has demonstrated changes in the microvasculature of skin associated with the severity of complications in patients with diabetes and peripheral vascular disease.
Dr. Rogers says the OxyVu-1 system acquires the image in 15 seconds and that physicians usually obtain three or four images of varying foot surfaces. HyperMed emphasizes that one can use OxyVu-1 in real time to predict outcomes, diagnose patients early and identify tissue pathology.
One benefit of the OxyVu-1 that other microvascular assessment tools do not share is that the product stores the images and physicians can view them later to determine the oxyhemoglobin levels in the peri-wound area or the proposed operative site, says Dr. Rogers.
He cites a recent study indicating that the OxyVu-1 predicted wound healing in patients with diabetic wounds. Dr. Rogers points out that the study, which assessed the use of the device in patients with diabetic foot wounds, showed a positive predictive value for wound healing of 93 percent.1
Dr. Rogers adds that current research is underway to study the use of this imaging system in predicting the level of amputation healing.
2. SensiLase (Vasamed). Another emerging option for assessing microvascular flow and wound healing potential is the SensiLase system.
SensiLase uses skin perfusion pressure (SPP) to measure microcirculatory values and assess the health of capillaries, according to Vasamed. The company notes the device also uses pulse volume recording (PVR), which tracks macrocirculatory values and measures changes in arterial blood volume. The device can help in managing chronic wounds that may be affected by compromised blood flow in the lower extremity, according to Vasamed. The company adds that the product can help determine the level of amputation and be helpful in diagnosing both peripheral arterial disease (PAD) and critical limb ischemia (CLI).