Volume 18 - Issue 3 - March 2005

Wound Care Q&A »

Key Insights On Selecting Wound Care Modalities

Clinical Editor: Lawrence Karlock, DPM | 10349 reads | 0 comments

   While there is quite an array of choices when it comes to choosing appropriate wound care modalities for lower-extremity wounds, there is not, as one panelist points out, a lot of published evidence for guidance. With this in mind, our expert panelists discuss a variety of wound care scenarios and how their clinical experience guides their decision-making on dressings and debriding agents.

   Q: Given the multitude of wound care dressings available, how do you narrow down your choice of wound dressings?

   A: Eric Espensen, DPM, and



Feature »

MRSA: Where Do We Go From Here?

By David G. Armstrong, DPM, MSc, PhD | 38570 reads | 0 comments

   Foot ulcers are a major predictor of future lower limb amputations. Fourteen to 24 percent of patients with diabetes with foot ulcers eventually require an amputation and more than 60 percent of nontraumatic lower extremity amputations occur in those with diabetes.1,2 Although risk factors may vary, the majority of diabetes-related amputations result from peripheral arterial disease, peripheral neuropathy or infection.3

   The healthcare costs associated with diabetic foot infections are staggering. In an analysis of medical and pharmac



Feature »

Current And Emerging Options For Treating Diabetic Neuropathy

By Stephanie Wu, DPM | 32261 reads | 0 comments

   Neuropathy is a common and debilitating complication of diabetes mellitus. According to data compiled by the National Institute of Diabetes and Digestive and Kidney Disease (NIDDK) and the American Diabetes Association (ADA), roughly 60 to 70 percent of the 18.2 million Americans with diabetes will develop some form of diabetic neuropathy and about 3 million patients with diabetes will experience painful neuropathy.

   There are three broad types of neuropathy (sensory, motor and autonomic) associated with diabetes. Sensory neuropathy is the most prevalent



Feature »

Point-Counterpoint: Active Charcot: Should You Proceed With Surgery?

By Peter M. Wilusz, DPM, Guy R. Pupp, DPM, and Molly Judge, DPM | 9583 reads | 0 comments

Yes, these authors say early identification of the Charcot process and prompt surgical intervention can prevent progression of the deformity and related complications.

By Peter M. Wilusz, DPM and Guy R. Pupp, DPM

   The presentation of Charcot neuroarthropathy has been historically problematic for the foot and ankle surgeon. Acute Charcot has traditionally been treated with conservative therapy as most attempts at treatment involve immobilization and removal of weightbearing forces from the involved foot. Many surgeons do not surgically address the acute Char



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Inside Secrets For Maximizing Efficiency

By Robert Smith, Contributing Editor | 3381 reads | 0 comments

   When a practice’s bottom line is not as strong as it should be, one should take a serious look at overhead costs but it is also important to look at how you and your staff are doing your jobs. There are things podiatrists can do to make more efficient use of staff, technology and process, and accordingly rein in runaway costs. Indeed, there are few practices out there that could not benefit financially from being more efficient.

    “The idea is to look from the outside in,” says Hal Ornstein, DPM. “You are always inside the operation and you cannot



Continuing Education »

How To Manage Heel Ulcers In Patients With Diabetes

By Jonathan Moore, DPM, and Pamela Jensen, DPM | 35097 reads | 0 comments

   Diabetic heel ulcers constitute one of the most frustrating problems for podiatric physicians. Pressure ulcers affect nearly 2 million people each year and account for annual healthcare costs that range between $2.2 billion and $3.6 billion. The heel is the second leading site for development of pressure ulcers after the sacrum.1 While patients with diabetes are living longer than in the past, the incidence of hospital-acquired heel ulcers increased from 19 percent in 1989 to 30 percent in 1993.2

   Costs for heel ulcers are nearly dou



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