Volume 17 - Issue 7 - July 2004

Feature »

Assessing The Role And Impact Of Enzymatic Debridement

By Jonathan Moore, DPM and Pamela Jensen, DPM | 12940 reads | 0 comments

Over the last few decades, many technological advances have occurred in the field of wound healing, resulting in a variety of wound dressings, ointments, creams, debriding agents, growth factors and bioengineered skin grafts. While one does not have to be a wound care specialist to treat complicated wounds, it is important to have a basic knowledge of normal wound healing and the etiology of a chronic or nonhealing wound, an understanding of the wound products available, and the ability to adapt to an ever-changing wound.
Chronic, delayed or non-healing wounds demonstrate an impaired response



Feature »

External Fixation: Is It The Answer For Diabetic Limb Salvage?

By Guy R. Pupp, DPM, and Peter M. Wilusz, DPM | 6395 reads | 0 comments

There has been a six-fold increase in diabetes mellitus over the last four decades in the United States.1 Indeed, 798,000 new diabetic patients are diagnosed each year in the U.S.2,3 The statistics are particularly disturbing when it comes to lower extremity amputation among people with diabetes.
Lower extremity amputation among the diabetic population increased from 67,000 in 1994 to 140,000 in 2000.4 While amputation in the diabetic population is a viable option in the presence of significant peripheral arterial disease and gangrene, life expectancy after m



Continuing Education »

How To Detect And Treat Infected Wounds

By John S. Steinberg, DPM, Khurram Khan, DPM, and Jonah Mullens | 14169 reads | 0 comments

In clinical practice, two of the most common types of infected wounds podiatrists see are ulcerations and postoperative incision sites. In order to resolve these infections and ultimately close these wounds, one must have a strong understanding of the etiology of infected ulcerations and post-op infections, how to assess these wounds and how to select appropriate treatment options.



Editor's Perspective »

Making The Right Call In Wound Healing

By Jeff Hall, Editor-in-Chief | 1309 reads | 0 comments

Consider the dizzying array of choices one must make when a patient presents with a non-healing wound. In some cases, determining the etiology can be a daunting challenge. In their guest column for Diabetes Watch, Damieon Brown, DPM, and Javier La Fontaine, DPM, discuss the difficulties of detecting diabetic autonomic neuropathy and provide an illuminating case study that reflects the subsequent challenges of treating these patients for chronic wounds (see page 20).
Within this month’s continuing education article, “How To Detect And Treat Infected Wounds” (see page 68), John S. Stei



Feature »

What You Should Know About Nutrition And Wound Healing

By Patricia Abu-Rumman, DPM, and Robert A. Menzies, BSc(Hons), MChS, SRCh | 11879 reads | 0 comments

Wound healing is a complex process that depends upon the delicate balance of physical and spiritual well-being of the individual. In order to maintain this required balance for wound healing, clinicians must be aware of and evaluate five major conditions including: adequate perfusion, decreased bacterial load, protection from mechanical stress, sufficient nutrition and the patient’s psychosocial status.
While one can evaluate the first three conditions through clinical examination techniques, laboratory assays and special studies, the nutritional status and psychosocial status of the patie



Letters »

Raising Questions About ESWT In Heel Pain Article

4244 reads | 0 comments

First, I’d like to say that the article on adult-acquired flatfoot (AAF) was insightful and thorough (see the cover story “A New Approach To Adult-Acquired Flatfoot,” pg. 32, May issue). It is now my reference on AAF. However, I found that the heel pain article left questions unanswered (see “Conquering Conservative Care For Heel Pain,” pg. 48, May issue). I wonder why James Losito, DPM, offered his comments on Extracorporeal Shockwave Therapy (ESWT) while having very limited knowledge of ESWT.

Out of the three methods of generating shockwave, Dr. Losito only describes one. By his



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