Sharp debridement is a critical step to promote healing and allow the body to repair chronic wounds as naturally and healthily as possible. Removing necrotic tissue and biofilm from the surface of chronic wounds converts chronic wounds into acute ones, effectively “resetting” the wound healing cascade and allowing the healing process to take place.
Successful... Read More.
It is estimated that Medicare spends $1.5 billion annually to treat diabetic foot ulcers (DFU).1 The debate continues on the cost effectiveness of immediate amputation in comparison with “conservative treatment” using a variety of modalities.
The cost of healing a DFU is related to its severity but detailed “cost to heal” data stratified by Wagner grade are... Read More.
Approximately 23.6 million people in the United States have diabetes, according to the 2007 statistics from the American Diabetes Association.1 Many of these patients have an associated comorbidity of obesity and, all too often, Achilles tendon contracture.
As we age, the tendon naturally tightens. However, diabetes exacerbates this tightening process as... Read More.
Before the advent of insulin, death from diabetes occurred early in the disease process. Now people with diabetes are living longer and long-term complications of the disease are more common. One such complication is Charcot arthropathy and since the early report by Jordan linking it to diabetes, the number of case reports has steadily increased.1
Although the... Read More.
We have all bemoaned non-adherent patients with out-of-control blood sugars who nod agreeably and then ignore everything we say. Not surprisingly, their wounds heal poorly and discouragement sets in with these patients. Their behavior appears to defy logic until we look at how prevalent depression and anxiety disorders are among patents with diabetes and how these disorders... Read More.
Gene therapy has entered the forefront of medicine and there may be potential benefits in all fields of healthcare. The potential for gene therapy to target disease has vastly expanded since the first successful human treatment for severe combined immune deficiency (SCID) emerged in 1990.
In podiatric medicine, one proposed target that has devastating... Read More.
For better or for worse, we live in an “As Seen on TV” culture. Often, our patients come to us with their own thoughts and ideas based on a commercial that they saw on late night television, an advertisement from the magazine on an airplane or something that they have “researched” on the Internet.
We would venture to guess that a week does not go by when a... Read More.
Intraepidermal nerve fiber density testing is gaining enthusiastic acceptance for the diagnosis as well as the staging of diabetic neuropathy. Studies have demonstrated reduced intraepidermal nerve fiber density in patients with diabetes type 1 and type 2.1 One major advantage of intraepidermal nerve fiber density testing is the ability to detect the presence of evolving... Read More.
The prevalence of individuals with diabetes continues to rise. The disease now affects nearly 24 million Americans or 7.8 percent of the population of the United States.1 Consequently, the demand for diabetic foot care continues to increase and this is exemplified by the one-year incidence of newly occurring ulcerations in patients with diabetes ranging from 1 to 2.6 percent. 2... Read More.
Podiatrists commonly encounter and treat skin and skin-structure infections (SSSIs), ranging from cellulitis to more complicated surgical site infections and infected diabetic foot ulcers. Aerobic gram-positive cocci, such as Staphylococcus aureus and streptococci, are the most common causative agents of skin infections.1
While the treatment of simple and superficial infections is relatively... Read More.
By Christopher L. Reeves, DPM,Alan A. MacGill, DPM,Amber M. Shane, DPM, and Joseph A. Conte, DPM
Clinical Editor: John S. Steinberg, DPM
Ankle fractures in patients with diabetes present a great challenge for the foot and ankle surgeon. Indeed, there is an abundance of literature documenting the difficulty of managing diabetic ankle fractures. Surgical treatment can be fraught with complications such as delayed bone and wound healing, and the development of Charcot neuroarthropathy.
When it comes to treating diabetic ankle... Read More.
Lower extremity complications associated with diabetes present a special challenge to any physician contemplating surgical management. Prophylactic foot surgery can be described as a procedure to prevent ulceration or re-ulceration in patients with diabetes without significant vascular compromise. This concept is part of a larger classification system, which stratifies the... Read More.