A Closer Look At Topical Therapies In Wound Care

Start Page: 68
John Giurini, DPM, FACFAS, and Allyson Berglund, DPM

In Conclusion

The underlying pathophysiology of DFUs and their associated chronicity are very complex. It is essential that the clinician recognize the potential underlying causes (both systemic and local in nature) of the DFU and manages these causes appropriately. A good clinical examination of the DFU is of the greatest importance as this will help guide the physician toward the most appropriate topical therapy and promoting an optimal wound healing environment.

   There are many available topical wound care products including products for dry/necrotic wounds, exudative wounds and wounds that are infected. Split thickness skin grafts and advanced biologics are also available for use in the appropriate situation. While the literature has shown success for the use of STSG and advanced therapies, there is little to no evidence supporting the use of one topical product over another topical product. Regardless, it is widely agreed upon that the clinician should choose a therapy based on the type of wound and its exudate.20,25

   Dr. Giurini is the Chief of the Division of Podiatric Medicine and Surgery at Beth Israel Deaconess Medical Center. He is an Associate Professor in Surgery at Harvard Medical School. Dr. Giurini is a Past President and Fellow of the American College of Foot and Ankle Surgeons.

   Dr. Berglund is the Chief Resident in the Division of Podiatric Medicine and Surgery at Beth Israel Deaconess Medical Center. She is a Clinical Fellow in Surgery at Harvard Medical School.

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