Volume 20 - Issue -
My favorite writing project is to produce a “return to work” document for a patient who has recovered from a serious foot or ankle problem. I had that pleasure last week on behalf of a 53-year-old gentleman whom I first met six months ago during a hospital consult.
His primary physician requested a consult regarding a diabetic ulcer with cellulitus involving the fourth and fifth toes of the left foot. The primary doc also let me know that he was beginning his vacation that day so I could manage the patient until he was ready for discharge. It all seemed like a convenien
In the podiatric profession, we are frequently faced with chronic painful musculoskeletal processes that get labeled as arthritis, chronic plantar fasciitis, neuroma, etc. Perhaps it would behoove us to start thinking of an underlying neurological pathology that may be responsible for foot or ankle pain.
In the senior author’s opinion, there is more neurological pathology causing foot and ankle pain than is being diagnosed. This may explain the cases in which patients have chronic musculoskeletal conditions and undergo surgery, but their pain never improves. Accordingly,
Preventing foot ulceration and re-ulceration in high-risk patients with diabetes is a challenge. Clinical outcomes are much better when high-risk patients receive proper foot care, education and protective shoes. There is a growing body of work which demonstrates that programs aimed at treatment and prevention significantly reduce ulcers, amputations and hospital admission.1-4 However, even at “centers of excellence for the diabetic foot,” the rate of ulcer recurrence is still very high.
In a randomized clinical trial, Uccioli reported a 28 percent re-ulceration rate
Approximately 50 percent of all sports injuries are secondary to overuse.1 Overuse injuries result from repetitive microtrauma that leads to local tissue damage in the form of cellular and extracellular degeneration. Injury is most likely to occur when an athlete changes the intensity or length of training. This has been described as the “principle of transition.”1 A discrepancy between work and recovery can lead to breakdown on a cellular, extracellular or systemic level. Other factors that can influence wear and tear include biomechanical abnormalities, poor train
The future of growth factor therapy in wound care is advancing rapidly. There is also increasing evidence in the literature to support the efficacy of growth factors in wounds, particularly chronic wounds, and how they can help facilitate desired healing outcomes. With advances in research over the past decades, physicians and researchers have teamed together to isolate and identify the disruption(s) in the sequence of wound healing that lead to chronic wounds.
Upon a closer examination of the phases of wound healing on the cellular level, it is clear that cytokines, particularly g
Continuing Education »
Continuing Education Course #157
I am pleased to introduce the latest article, “A Guide To Current Concepts In Skin Grafting,” in our CE series. This series, brought to you by the North American Center for Continuing Medical Education (NACCME), consists
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