Volume 16 - Issue 7 - July 2003

Surgical Pearls »

How To Minimize Post-Op Pain After Reconstructive Surgery

By J. Michael Miller, DPM | 9798 reads | 0 comments

Minimizing postoperative discomfort for patients is a common goal of all surgeons. Techniques for achieving this goal seem to vary significantly among surgical specialties. Unfortunately, patients often have preconceived expectations that they will experience considerable discomfort after foot surgery. This is usually based on their experience with other surgical procedures or from discussions with other people in their community who have expressed their “experience” with foot surgery.
This fear of significant postoperative discomfort occasionally will preclude some patients from undergo



Wound Care Q&A »

Roundtable Insights On Hyperbaric Oxygen Therapy

Clinical Editor: Lawrence Karlock, DPM | 15113 reads | 0 comments

While there is not an overwhelming amount of literature on hyperbaric oxygen therapy (HBO), the recent decision by the Centers for Medicare and Medicaid Services (CMS) to cover the use of HBO in treating diabetic foot wounds has fueled new discussions on the potential efficacy of the modality. With this in mind, our panelists discuss their experiences in using HBO, the current literature on the subject and reimbursement issues.

Q: What has been your experience in using hyperbaric oxygen therapy (HBO) to treat lower extremity wounds?
A:
Leon Brill, DPM, says he has had a “very posi



Technology In Practice »

Can The Active Off-Loading Insole Reinvent Care For Plantar Ulcers?

By Robi Garthwait, Contributing Editor | 6073 reads | 0 comments

With the rate of diabetes cases skyrocketing and the number of lower-limb amputations also on the rise, a new insole may provide hope for those suffering the adverse effects of plantar ulcers. Used in conjunction with the company’s Active Off-Loading Walker (formerly known as the DH Walker), Woundcare Shoes or DH Pressure Relief Shoe, Royce Medical’s Active Off-Loading Insole has been deemed “the platinum solution for healing plantar ulcers.”
Hoping to alleviate some of the pain and trauma associated with treating plantar ulcers, the company set out to provide an “active environment



Point-Counterpoint »

Are Tissue Replacements Cost Effective?

25181 reads | 0 comments

Yes, these authors say tissue replacements can facilitate shorter healing times and reduce the risk of complications from chronic wounds.

By Jason R. Hanft, DPM, Andre Williams, DPM, Constantine Kyramarios, DPM, and Kerry Temar, DPM, MS

The goals in treating diabetic foot ulcers are to obtain wound closure as quickly as possible, lower the probability of amputation and decrease recurrent ulcerations. Timely healing is important because the longer a diabetic foot ulcer remains unhealed, the greater the risk for infection, hospitalization and progression of the ulcer to require lim



Feature »

Achieving Adjunctive Success With Wound Dressings

By Alan J. Cantor, DPM, CWS | 12294 reads | 0 comments

The wound care industry has produced and marketed a flurry of new options for clinicians in a very short period of time. Indeed, some experts wonder whether this has created confusion among clinicians, further widening the gap between academic clinicians and those who are in everyday community or office settings.1 As Professor Terence Ryan pointed out, “There is a difference between the ‘gold standards’ of the elite and the logistics of providing care in the environments of those with limited access to expertise.”2
A February 2002 survey of podiatrists in the Un



Feature »

A Guide To Closure Techniques For Open Wounds

By Thomas Zgonis, DPM, Gary Peter Jolly, DPM, and Peter Blume, DPM | 11264 reads | 0 comments

The soft tissue envelope of the foot resists severe mechanical stresses on a daily basis and protects the underlying structures from injury. However, an injury to the foot or a chronic ulcer can cause a defect in the soft tissues and presents a daunting challenge for the foot and ankle specialist. When the defect is on the sole of the foot, the injury may be disastrous.
Historically, soft tissue lesions have been treated conservatively via various techniques of offloading, local wound care, molded shoes, inserts and orthoses. While some wounds lend themselves well to non-operative treatment,



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