Approximately 15 percent of all patients with diabetes can be expected to develop ulceration in their lifetime, thus putting them at risk for lower extremity amputation. Treatment for infected diabetic foot wounds accounts for one quarter of all diabetic hospital admissions in the United States and Great Britain.1-3 Patient education, proper footgear and regular foot examination can decrease the... Read More.
Ciclopirox has been well documented as a broad-spectrum antifungal agent with additional antibacterial and antiinflammatory properties.1-3 However, in recent studies reported by Linden, et al., ciclopirox has also demonstrated potent angiogenic activity, which suggests that the drug may have certain wound-healing properties.4 If this is borne out by larger studies in the future... Read More.
Many exciting antibiotics have either recently been approved, received a new FDA indication or will soon become available. Some are well known and have already been incorporated into clinical practice. Many are the first in their respective classes and have novel mechanisms of action. What place, if any, do these drugs have in the treatment of diabetic foot infections (DFIs)?... Read More.
One will not find combination therapies mentioned in evidence based medicine (EBM) journals or in research trials. In fact, one will rarely find combination therapies mentioned in many trade publications either. Purists often claim this concept presents a mixed message. How can one track performance and outcomes if he or she is using combination therapies? What component worked... Read More.
As we evolve in our treatment of foot and ankle conditions, it seems like each treatment meets with some reservation from the medical community. As podiatric physicians, our mindset is scientific in nature and we need hard facts and evidence-based results to show each treatment option is beneficial. I am with the mainstream in that thinking but I also try to rationalize a... Read More.
By Stephanie C. Wu, DPM, MS, Hong Yoon, MS, and David G. Armstrong, DPM, MSc, PhD
Skin ulceration of the lower extremity affects millions of people in the United States alone and may be secondary to a myriad of etiologies including pressure, metabolic, trauma, venous, arterial and diabetic neuropathy.1 The medical, psychosocial and financial impacts imposed by lower extremity ulcerations are tremendous. The attributable cost for the treatment of chronic lower... Read More.
In spite of efforts to control diabetes and improve limb salvage rates, the number of diabetes-related amputations continues to rise in the United States. Over 80,000 amputations are performed each year, with approximately one-half being partial foot procedures and one-half being transtibial or higher amputations.1 By evaluating and identifying patients at risk for amputation,... Read More.
Complications related to obesity have been a topic of concern for health officials since the 1950s. However, it has only been in the past few years that a widespread epidemic has reached alarming proportions in the United States and worldwide, leading to substantial health and economic costs. In the U.S., obesity is largely linked to an increase in the incidence of type II... Read More.
Approximately 3 percent of the United States population has diagnosed diabetes mellitus.1 Diabetic foot problems, however, are the leading cause of amputation.2,3 The risk of amputation is 15 times greater in patients with diabetes than in other people.2 Up to 15 percent of patients with diabetes will require amputation.1,3 Over 50,000 amputations in patients with diabetes occur... Read More.
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... Read More.
The Charcot foot and ankle is a challenging clinical entity for the qualified foot and ankle surgeon. It is a progressive disease with insidious onset. Osteoarthropathy was originally described in 1703 but it wasn’t until 1868 that it was called Charcot neuroarthropathy due to Charcot’s work in linking the disease to tabes dorsalis and neuropathy.1,2 It was Jordan who linked this destructive... Read More.
By Chad Friedman, DPM, Elizabeth Bass, DPM, and John Steinberg, DPM
Given the increasing prevalence of antimicrobial resistance, there is a growing interest in emerging wound care products that contain silver. Topical silver has a broad range of antimicrobial activity and has been used extensively to help treat high-risk burn patients. Research has confirmed that silver is effective against gram negative and positive bacteria, methicillin resistant Staph aureus (... Read More.