Treating the diabetic foot is relatively straightforward. We need to ensure that blood flow is adequate, eradicate infection, eliminate pressure from the wound site and regularly remove the dead and devitalized tissue from the affected area. If we do all those things, the wound heals. It really is that simple.
However, the pathway to get to that point is often quite convoluted... Read More.
A patient with diabetes mellitus has a 15 to 25 percent chance of developing a diabetic foot ulcer during his or her lifetime.1 Once the patient with diabetes develops an ulcer, there is an even higher rate of ulcer recurrence at 50 to 70 percent over five years.1
Diabetic foot ulcers are notoriously slow to heal and often lead to complications such as life-threatening... Read More.
Cynthia Cernak, DPM, Robert H. Odell, MD, PhD, and Peter Carney, MD
In the United States and most developed countries, medical care focuses more on the treatment of acute disease than chronic diseases, even though chronic disease processes consume a large proportion of healthcare resources. Currently, we treat peripheral neuropathy, caused by diabetes and other processes, by controlling its symptoms and not healing damaged nerves. A new technique utilizing the... Read More.
Podiatrists play a critical role in the identification, treatment and management of patients with peripheral arterial disease (PAD). While an estimated 8 to 12 million Americans have PAD, the disease continues to remain largely underdiagnosed.1 Symptoms of pain, aching or cramping in the legs with walking (claudication) can occur in the buttock, hip, thigh, or calf.1 However, up to 75 percent of... Read More.
In recent years, the concept of multidisciplinary wound care has gained increasing momentum. Wound care journals cite example after example of podiatrists teaming with various disciplines including vascular specialists, nutritionists, endocrinologists, infectious diseases specialists and nurses from different care settings.1 This type of collaborative effort has certainly benefited patients. In... Read More.
The diabetic population in the United States has grown to over 26 million people and 10 to 15 percent of this population will develop a diabetic foot ulceration (DFU).1,2 That would equal 2.6 to 3.9 million diabetic foot ulcerations in this country. Diabetic foot ulcerations precede 85 percent of all non-traumatic lower extremity amputations and it is known that patients with diabetes who have an... Read More.
Keith D. Cook, DPM, FACFAS, Carl Brandon Lindberg, DPM, and Joseph Genualdi, DPM
Ankle fractures are very common injuries that foot and ankle surgeons see. An estimated 585,000 ankle fractures occur in the United States each year and 25 percent receive surgical intervention.1 Ankle fractures are the most common intraarticular fracture of a weightbearing surface and account for 9 percent of all fractures.1
Management of ankle fractures in the subpopulation... Read More.
The treatment of diabetic neuropathic pain is complex and often unsatisfactory clinical results plague the patient with diabetes and the treating physician. Historically, physicians have used systemic pharmacologic treatments with mixed results and undesirable side effects. These have included antidepressants, anticonvulsants, N-methyl-D-aspartate (NMDA) receptor antagonists and opiate analgesics... Read More.
Patients with diabetes are no strangers to dealing with the complications associated with their disease. As foot and ankle surgeons, we also often face the challenge of treating the complications and sequelae of this pathologic process including lower extremity deformity, non-healing wounds, Charcot neuroarthropathy and infection to name a few.
However, what happens when we, as... Read More.
E. Giannin Perez, DPM, MS, and Khurram H. Khan, DPM, FACFAS
Wound healing is a challenging task for any podiatric physician, especially for our high-risk patients with diabetes. Uncontrolled diabetes has consequences for all aspects of the body but is especially detrimental to wound healing. Patients with diabetes have a 15 to 25 percent lifetime risk of developing foot ulcers and their annual treatment costs are estimated to be about $30,000.1
... Read More.
Currently, in the United States, the Centers for Disease Control and Prevention (CDC) reports there are approximately 25.8 million people with diabetes mellitus, which is 8.3 percent of the population.1 This number is estimated to grow to 44 million by the year 2034.
One of the most feared complications for the patient with diabetes is amputation. More than 60 percent of non-... Read More.
Sara L. Borkosky, DPM, AACFAS, and Thomas S. Roukis, DPM, PhD, FACFAS
Diabetes mellitus with peripheral sensory neuropathy and the associated increased risk of ulceration continue to be growing issues in today’s society.1-28 Peak ambulatory forces occur about the first ray, creating a cycle of stresses, tissue buildup and eventual breakdown.2 Conservative therapies often fail due to an inability to offload the wound properly, poor pedal hygiene and inadequate... Read More.