Podiatry Today Current Issue

How To Address Puncture Wounds

admin — Wed, 03 Sep 2008 17:01:48 -0400

Please click here for the full Continuing Medical Education article:

http://www.naccme.com/program/pd-2008-7/

Given the challenges of treating puncture wounds, these authors emphasize a thorough diagnostic work-up, review pertinent guidelines and explore current concepts on the use of prophylactic antibiotics.

A Closer Look At The Research On Bilayered Living Cell Therapy

admin — Wed, 03 Sep 2008 17:01:48 -0400

Diabetic foot ulcers are among the many complications encountered with poorly controlled diabetes mellitus. Approximately 15 percent of all patients with diabetes will experience an ulcer in their lifetimes.^1,2 Additionally, 85 percent of all nontraumatic lower extremity amputations are preceded by a preventable ulceration.^3,4

Diabetic foot ulcerations pose a considerable economic burden. In 1995, Medicare spent $1.5 billion on diabetic lower extremity ulcers.⁵ One retrospective analysis found that foot ulc

Weighing In On The Evidenced-Based Medicine Debate

admin — Wed, 03 Sep 2008 17:01:48 -0400

I have just finished reading the article, “EBM: Can It Be A Reality In Practice?” (see page 38 in the May issue).
I acknowledge and understand the viewpoints presented in the article.
However, if we all waited for articles to be peer reviewed before trying a new treatment, how would this help patients currently? When a new technology or modality appears, and it is presented in a journal that is not peer reviewed, should we be skeptical of using the modality on our patients?
Someone has to take the initiative to try the new product and report back to

How To Address Vascular Complications With Lower Extremity Wounds

admin — Wed, 03 Sep 2008 17:01:48 -0400

Our contemporary knowledge and critical limb ischemia (CLI) tools have allowed us to dispel many myths regarding the endovascular treatments of lower extremity disease and CLI. These tools are not perfect but they have greatly improved over the last decade and certainly over the last two to three years. One of the biggest complaints I hear from podiatrists is “the surgeons and interventionalists in my area do not believe these things work.” Accordingly, let us take a closer look at some of these myths and the corresponding realities.

Myth: Most CLI patien

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Assessing Vascular Surgery Options In Patients With PAD

admin — Wed, 03 Sep 2008 17:01:48 -0400

Peripheral arterial disease (PAD) is a very common condition that affects 20 to 30 percent of patients over 50 years of age, equating to an estimated 10 million Americans. As the population ages, the incidence of PAD will likely increase dramatically.¹
Intermittent claudication is a symptom among patients with PAD and one can use the presence of these symptoms as a diagnostic tool.² True claudication is an aching or cramping within the muscles in the involved extremity that is exertion-related, relieved by rest and occurs at a relatively constant walking

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How To Get Better Results With Bunion Surgery

admin — Wed, 03 Sep 2008 17:01:48 -0400

Bunion surgery is perhaps the most common procedure we perform in podiatry. Since bunions come in all shapes and sizes, several different types of procedures have emerged along with various refinements over the years.
Accordingly, let us take a closer look at what makes these procedures work well. Conversely, we need to ask some tough questions.Why do some bunion surgeries fail? Why do some people seem to recover better than others? How can we minimize poor outcomes? Our group has been involved in many revision bunion surgeries so there is a certain level of failures and compl

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Can Calcium Phosphate Bone Cement Aid In Hallux Valgus Repair?

admin — Wed, 03 Sep 2008 17:01:48 -0400

Over the years, hallux valgus repair has evolved from simple bunionectomies to complex and multiple osteotomies. The keys to a successful outcome are the realignment of the structural abnormalities and a stable postoperative environment.The former is important for proper function and the latter facilitates the healing process.
With this in mind, let us take a closer look at the potential benefits of utilizing calcium phosphate bone cement (OsteoVation^™, OsteoMed Corp.) for filling voids in metatarsal osteotomy-type bunionectomies to achieve a favorable surgica

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Secrets To Motivating Your Staff

admin — Wed, 03 Sep 2008 17:01:48 -0400

Motivation does not always come wrapped in a dollar bill.Yet whenever the topic of “staff incentive” comes up, so does the topic of money. Even though I try to emphasize that it takes more than cold hard cash to incentivize staff, far too many physicians are unable to grasp this notion and keep reverting back to the bankroll in an effort to “buy” their staff ’s enthusiasm.
One survey, conducted by the late Kenneth Kovach, PhD, of the University of Maryland, found a significant disconnect between what employees actually want from a job and what man

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Point-Counterpoint: Extracellular Matrices: Are They Worth It?

admin — Wed, 03 Sep 2008 17:01:48 -0400

Yes. By Dr. Steven R. Kravitz, DPM. This author says podiatrists should consider extracellular matrix enhancement for chronic, complex wounds that do not respond to standard of care therapy.

Over the past 10 years, there have been paradigm shifts in intervention for chronic non-healing wounds. There has been an increased emphasis on moist wound healing,wound bed preparation and managing the wound microenvironment through bone factor enhancement, matrix metalloprotease (MMP) management and bioload reduction.
There has also been a new emphasis on e

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CDC Looks At Exercise Limitations Among People With Diabetes And Arthritis

admin — Wed, 03 Sep 2008 17:01:48 -0400

Getting patients with diabetes to exercise may be an uphill battle due to disease concerns. The combination of arthritis with diabetes can be an additional barrier to activity, according to a large survey conducted by the Centers for Disease Control and Prevention (CDC).
The CDC utilized 2005 and 2007 data from the Behavioral Risk Factor Surveillance System (BRFSS), which surveyed hundreds of thousands of people across the United States and its territories. The BRFSS survey indicated that the prevalence of arthritis in adults diagnosed with diabetes was 52 percent. Furthermore

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