Volume 20 - Issue 7 - July 2007
It has been estimated that a person with diabetes has a 25 percent lifetime risk of developing a foot ulceration.1 Diabetic foot ulcers commonly become infected, can involve bones and joints and may progress to amputation. Osteomyelitis frequently complicates ulcerations in people with diabetes and may be present in up to 20 percent of mild to moderate and 50 to 60 percent of severely infected wounds.2
Continuing Education » MRSA
Given the increasing prevalence of methicillin resistant Staphylococcus aureus (MRSA), these authors discuss the differences between HA-MRSA and CA-MRSA, what the literature reveals about antibiotic therapy and keys to the diagnostic workup of these patients.
Vacuum Assisted Closure (VAC, KCI) may be the most impressive device for the foot since AO fixation revolutionized elective foot surgery. For large or difficult wounds, VAC therapy can rapidly improve granulation tissue and speed up coverage of exposed tendon and bones. Indeed, this often occurs in days to weeks rather than months. Most clinicians are convinced at the bedside when they see dramatic changes in the characteristics of a wound such as size, depth and exposed structures.
There is a growing body of evidence that supports the clinical observations and animal research that have be
Technology In Practice »
The recent introduction of longer surgical screws may facilitate improved outcomes with lesser digital arthrodesis procedures.
The new Cannulated Titanium Lag Screws stand out with a thinner and longer profile, making them “ideal for severe digital deformities,” according to the manufacturer OsteoMed.
The 2.0 mm screw ranges between 6 to 42 mm in length and the 2.4 mm screw ranges between 6 to 50 mm in length. David J. Freedman, DPM, FACFAS, who is in private practice in Silver Spring, Md., says the screws are long enough that podiatric surgeons are able to complete an arthrodesis on th
New Products »
A new Doppler can document a patient’s vascular status from a number of angles.
The Smartdop® 30EX is a lightweight, portable, bidirectional Doppler with a printer and large LCD display, according to the manufacturer Koven Technology. The device has an automatic cuff inflator which the company says aids in fast and accurate testing for ankle-brachial indices and tibial-brachial indices.
With the Smartdop 30EX, one can use the Smart-V-Link® Software to save up to 30 waveforms. The company says one can calculate ratios automatically and optional PPG models are ava
Making hospital rounds to care for patients with infections and diabetic wounds is at times depressing. This morning’s rounds were particularly difficult.
My first patient was a 53-year-old heavy equipment operator who had just lost his fourth and fifth rays due to diabetes and gangrene. It is not likely that the wound will heal. He is single and does not get many visitors. He seems sad and tired of fighting.
My second patient is a 47-year-old high school teacher. She is in denial about the seriousness of her mixed infection that is destroying her foot and leg. She keeps talking about nee