Volume 16 - Issue 7 - July 2003
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
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
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,
Continuing Education »
Neuropathic osteoarthropathy, or Charcot arthropathy, is a condition associated with a loss of sensory nerve function and concurrent vascular dynamic changes. In the acute setting, Charcot can result in bone and joint deformation and fragmentation. If it is not treated early and aggressively, the collapse of involved joints will cause instability, deformity and subject bony prominences to ulceration and infection.
The incidence in the United States and internationally of those with diabetes who have Charcot arthropathy ranges from 7.5 to 13 percent. Internationally, 10 to 20 percent of tho
Treating chronic lower extremity ulcerations successfully depends on how well one understands the complex and dynamic interaction of multiple factors that contribute to the slow or non-healing nature of these ulcerations. Wound bed preparation, which is essential to managing difficult ulcerations, involves exudate reduction, appropriate debridement and the reduction of the wound’s bioburden. Indeed, removing the local barriers to healing will prepare the wound bed to support the activities necessary for wound healing.
The process of wound bed preparation begins with the initial evaluatio
Editor's Perspective »
The avalanche of bad news is unrelenting. The medical malpractice crisis seems to be getting worse. In addition to the 18 states already declared as “crisis” states by the American Medical Association, physicians in another 26 states are facing escalating insurance premiums as well, according to a recent article in The New England Journal Of Medicine. Combine that with dwindling reimbursement for services and even the most dedicated physician would be hard-pressed for an optimistic view.
However, in the midst of all this depressing news, there is a very intriguing study that reaf