Volume 20 - Issue 3 - March 2007

Wound Care Q&A »

Current Concepts In Treating Ischemic Foot Ulcers

Clinical Editor: Lawrence Karlock, DPM | 18445 reads | 0 comments

     When it comes to patients with ischemic foot ulcers, potential complications can be dire. Accordingly, it is important to have a firm grasp on diagnostic studies as well as current and emerging treatment options that may enhance outcomes for patients.

     With this in mind, our expert panelists discuss a range of issues related to the ischemic foot.

     Q: How do you approach/work up the ischemic foot ulcer patient?
     A:
David E. Allie, MD, works up such patients “very, very aggressively.” Of the approxi



Surgical Pearls »

Can Alternative Fixation Foster Better Outcomes With The Akin Osteotomy?

By Anthony Weinert, DPM, Ali Elkhalil, DPM, and Ahmad Farah, DPM | 7016 reads | 0 comments

      Practitioners have described various osteotomies for the proximal hallux. However, the Akin closing wedge osteotomy is currently the most common procedure. Podiatric surgeons commonly employ the transverse plane closing wedge osteotomy for the correction of hallux abductus interphalangous deformity. One may also use this as an additional procedure for the correction of hallux abductovalgus deformity.

      Akin noted that one should perform the closing base wedge osteotomy at the proximal one-third of the proximal hallux and orient it in the transverse p



Feature »

Current Concepts In Diabetic Foot Surgery

By Jarrett D. Cain, DPM, and Vickie R. Driver, DPM, MS | 12057 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 | 10117 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 | 10570 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 | 23279 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