Podiatry Today Current Issue

Study: Infection Dramatically Raises Risk Of Amputation, Hospitalization

admin — Wed, 03 Sep 2008 17:01:42 -0400

It is no secret that foot infections can lead to a range of complications up to and including lower extremity amputation. However, a recent study has demonstrated a dramatically higher risk of both amputation and hospitalization in diabetes patients who develop foot infections as opposed to those without infection. The authors say this is the first prospective study to report the incidence of foot infections in a defined population as well as the risk factors for infection.

The study, published in a recent issue of Diabetes Care, found that patient

Emphasizing The Need For Accelerated Wound Healing

admin — Wed, 03 Sep 2008 17:01:42 -0400

The importance of resolving infections and facilitating quicker wound healing is commonly understood when it comes to managing lower extremity ulcerations in patients with diabetes. Indeed, a recent study in Diabetes Care emphasizes just how important those treatment goals are in the diabetic population.

According to the study, those who have a diabetic foot infection have over a 150 times greater risk of amputation and a 55.7 times increased risk of hospitalization than those without infection (see page 10, “News and Trends”).

Can A Gastric Bypass Procedure Have A Positive Impact On Diabetes?

admin — Wed, 03 Sep 2008 17:01:42 -0400

The complications stemming from obesity have been well documented. In recent years, the popularity of the gastric bypass procedure has increased as a method of combating obesity. As the literature shows, gastric bypass has a positive effect on diabetes itself as well as diabetic neuropathy. However, the surgery is not without its risks and the entire health care team must be aware of both the benefits and downsides.

According to data from the 1999-2000 National Health and Nutrition Examination Survey, two-thirds of the United States population is overwe

Key Insights On Treating Burn Wounds In The Lower Extremity

admin — Wed, 03 Sep 2008 17:01:42 -0400

Treating partial- and full-thickness burns present unique challenges for podiatrists. Although one may need to refer burns to a burn center, there are measures DPMs can take to treat burns and help relieve the patient’s pain. Accordingly, these expert panelists discuss their preferred modalities for wounds, methods of management and their thoughts on the role of bioengineered tissues and oral antibiotics.

Q: What is your initial management of lower extremity burn wounds as far as partial-thickness (second degree) versus full-thickness (third degree)

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Transverse Z-Osteotomy: Is It A Viable Adjunctive Option For Hallux Limitus?

admin — Wed, 03 Sep 2008 17:01:42 -0400

   There have been many surgical treatment modalities described in the podiatric and orthopedic literature for the correction of hallux limitus.^1-5 Since the Regnauld procedure was introduced in 1968, surgeons have used it in the treatment of a pathologically long proximal phalanx and hallux limitus.⁶ However, since its development, this procedure has been characterized as a technically challenging procedure for the treatment of hallux limitus with or without moderate degenerative arthritis.^7-10

   In 1995, Kissel, et. al., and

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A Closer Look At Bioengineered Alternative Tissues

admin — Wed, 03 Sep 2008 17:01:42 -0400

   The medical management of wounds today is vastly different than wound management was a few years ago. Evidence-based research has provided the practitioner with new technologies that can predictably heal wounds that previously would have threatened limb loss.

   The team approach to complex wound management has been widely embraced and many communities now have referral centers and hospital-based teams that provide multidisciplinary care. With an estimated 20.8 million people in the United States now affected by diabetes and a 15 percent lifetime incidence

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How To Choose Appropriate Antibiotics For Diabetic Foot Infections

admin — Wed, 03 Sep 2008 17:01:42 -0400

   Diabetes is clearly an epidemic in this country. According to the most recent statistics from the Centers for Disease Control and Prevention, 18.2 million people in the United States have the disease and 1.3 million new cases are diagnosed each year. Foot infection is the most common reason for lower extremity amputation and leads to billions of dollars a year in hospitalization costs in this country alone.

   Despite becoming almost commonplace, diabetic foot infections are often mismanaged, particularly with regard to antibiotics. The solution to this pro

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Is There A Role For ESWT In Wound Care?

admin — Wed, 03 Sep 2008 17:01:42 -0400

   Over the past several years, there has been a developing body of knowledge regarding the clinical applications of extracorporeal shockwave therapy (ESWT). The latest area of clinical investigation for this technology is in the arena of wound healing. Researchers are now studying ESWT as a new approach to wound healing with a particular emphasis on complex soft tissue wounds with and without underlying bone disruption. Hopefully, this article will serve as an introduction to this new topic and we hope the evidence-based data will soon follow as the ongoing clinical trials prog

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Key Insights On Mapping Wounds With Ultrasound

admin — Wed, 03 Sep 2008 17:01:42 -0400

   During the last few years, improvements continue to abound in wound care treatments and therapeutics. Specialized dressings, circulation boots, monochromatic infrared therapy, skin substitutes and negative pressure therapy along with variety of vehicles to deliver silver are only a few of the advances. There have also been emerging developments in the diagnostic arena, including thermography, infrared temperature devices, pressure detection mats and devices to test for sensory defects and neuropathy.

   Despite all of these advances, standard wound care (sha

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How To Develop A Long-Term Plan For Practice Transition

admin — Wed, 03 Sep 2008 17:01:42 -0400

   A detailed assessment of the day-to-day operations, billing and marketing of a podiatric practice can greatly enhance one’s results while planning a personnel transition within the practice.

   With this in mind, I conducted an operational and revenue analysis for a doctor with the objective of helping him to plan for the future of his practice and the location of his practice.

   The analysis has a couple of key sections. First, we reviews the processes in the doctor’s office such as scheduling, patient intake and patient flow. We mo

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