Volume 19 - Issue 6 - May 2006
Editor's Perspective »
You wouldn’t think it would take much persuading to convince patients with diabetes to regularly monitor their blood sugar or stay off of a recently treated foot wound given the potentially serious consequences of not doing so. Yet the statistics tell us a different story. In an intriguing, retrospective study published in the February 2005 edition of WOUNDS, researchers found that patient compliance was poor in 79 percent of patients with diabetes that eventually succumbed to amputation.
Experts say there are things clinicians can do to identify obstacles to compliance. It starts
News and Trends »
Various classification systems categorize diabetic wounds and infections. One system, devised in 2003, categorizes different levels of non-vascular diabetic foot surgery. How effective is such a system? A recent study, the first to evaluate the system’s effectiveness, suggests including various risk factors in the system may better predict surgical complications.
The study, presented as an abstract at the American College of Foot and Ankle Surgeons Annual Scientific Meeting, evaluates the classification system’s four categories: elective, prophylactic, curative and emergency surgery. Res
Diabetes Watch »
Given the increasing prevalence of antimicrobial resistance, there is a growing interest in emerging wound care products that contain silver. Topical silver has a broad range of antimicrobial activity and has been used extensively to help treat high-risk burn patients. Research has confirmed that silver is effective against gram negative and positive bacteria, methicillin resistant Staph aureus (MRSA), yeast, filamentous fungi and viruses (including varicella zoster and herpes simplex types I and II).1-4
Interestingly, the use of silver for medicinal purposes has been docume
Surgical Pearls »
The etiology of heel pain is quite varied. First described by Wood in 1812, the most common cause is thought to be plantar fasciitis. This is typically marked by focal tenderness to any component of the aponeurosis but most frequently at the proximal medial insertion of the plantar aponeurosis.1
Many symptomatic patients with plantar fasciitis demonstrate plantar heel spurs (traction enthesopathies) of the os calcis. One may best appreciate this shelf of exostosis on the lateral and lateral oblique views of standard radiographic studies.2 On rare occasions, fracture of
“Collapsing” pes planovalgus or flexible flatfoot is a complex pedal pathological condition with numerous components. In its most significant form, the condition can lead to significant disabling and an inability to ambulate efficiently. Arthroereisis is a relatively modern surgical technique one may employ for pes planovalgus correction.
Arthroereisis is defined as the limitation of exogenous joint motion without complete arthrodesis. This procedure, which involves placing a motion blocking implant within the sinus tarsi, has been designed to restrict excessive subtalar joint (STJ) pron
Plantar fasciitis is often inaccurately referred to as “heel spur syndrome.” Clinicians should no longer use this terminology. Most of the time, the presence or absence of a plantar calcaneal spur has no effect on symptoms or treatment. The term fasciitis may also be a misnomer. Lemont studied the pathology of 50 patients who underwent fascial release surgery.1 The findings did not show any evidence of inflammatory cells within the fascia. The common finding was degeneration of the tissue. The inflammation appears to be in the underlying intrinsic musculature so perhaps the corr
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