Volume 20 - Issue 3 - March 2007

Feature »

Current Concepts In Diabetic Foot Surgery

By Jarrett D. Cain, DPM, and Vickie R. Driver, DPM, MS | 13118 reads | 0 comments

      Patients with diabetes can be a quite an undertaking for any physician who manages them on a consistent basis. In the past, this has created reservations when it comes to managing these patients especially from a surgical standpoint. However, over the years, with greater understanding of the disease, improvements in surgical techniques and emerging research, the reservations have diminished and the role of surgical management is a viable option when it comes to successfully treating those with diabetic ulcerations, infections and other related complications that exist in t



Feature » MRSA

Point-Counterpoint: Should You Cover MRSA?

By Guy R. Pupp, DPM, FACFAS, and Mark A. Kachan, DPM; By Warren S. Joseph, DPM, FIDSA | 11065 reads | 0 comments

      Yes. By Guy R. Pupp, DPM, FACFAS, and Mark A. Kachan, DPM. Given the increasing incidence of methicillin-resistant Staphylococcus aureus, one should consider empiric coverage against MRSA in high-risk patients with infected ulcerations in the lower extremity.

      The most common pathogens in nosocomial skin and skin structure infections in the United States and Canada in 2000 were Staph aureus. Researchers have stated that approximately 30 to 60 percent of all Staph aureus isolates are methicillin-resistant Staph aureus (MR



Feature »

A Guide To Surgical Offloading In The Neuropathic Foot

By Rachel Grieder, DPM, Sean McMurray, DPM, and Matthew J. Claxton, DPM | 11517 reads | 0 comments

      The neuropathic foot presents unique challenges when treating and preventing chronic wounds. One of the most difficult challenges is offloading the neuropathic foot without compromising function or causing a transfer of pressure that leads to further ulceration. When performing a limb salvage procedure, the goal is to provide the patient with a stable, plantargrade foot while still allowing for ambulation.1

      In choosing the appropriate procedure to offload the foot, it is important to consider minimal bone resection versus a partial pedal



Feature »

Honey-Based Dressings: Can They Have An Impact For Diabetic Foot Ulcers?

By Wendy Tyrrell MEd, DPodM, MChS, and Rose A. Cooper, PhD | 25596 reads | 0 comments

     Honey is an ancient wound remedy that is reappearing in clinical practice in developed countries. The availability of licensed wound care products in Europe, New Zealand and Australia is prompting healthcare practitioners in conventional medicine to consider the use of honey within their treatment armamentarium. Ulcer remedies such as honey are necessary as the prevalence of diabetes rises.

     The American Diabetes Association has estimated that about 7 percent of the population had diabetes.1 It is an increasing problem that has serious impl



Feature »

How To Address Predislocation Syndrome Of Lesser MPJs

By William D. Fishco, DPM, FACFAS | 66055 reads | 1 comments

     Metatarsalgia is a diagnostic term used to describe pain in the ball of the foot. Gerard V. Yu, DPM, eloquently described and illustrated predislocation syndrome in 1995. What Dr. Yu described was a clinical syndrome characterized by focal pain under a lesser metatarsophalangeal joint (MPJ), most often affecting the second toe joint.1

     Subjective symptoms reported by those afflicted with this syndrome would be described as a “grape-like” swelling under the affected toe joint, and a feeling as if there were a stone bruise on the ball of



Feature »

Secrets To Facilitating Patient Adherence

By Kathleen Satterfield, DPM | 5188 reads | 0 comments

     The basic question is really “How do you get someone to do something that they do not especially want to do?” The fictional Tom Sawyer was the classic king of this skill but as physicians, we are trying to do something a bit more complicated than getting someone to paint a fence. We are trying to get our patients to adhere to the instructions of given treatment regimens, such as taking a confusing regimen of pharmaceuticals or staying off an injured foot.

     Although the word “non-compliance” is not in the title of this article, be assured that



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