Wound Care Q&A

10,157 reads | 0 comments
The array of wound care products can be quite astounding. Choosing the right product(s) for your patient can be difficult. With this in mind, our panelists, strongly emphasizing case-by-case management, share their experiences, success stories and caveats with certain wound care products. Read on for what five expert panelists had to say about treating neuropathic ulcers, when to use growth... Read More.
17,271 reads | 0 comments
Many patients with non-healing ulcers are already in significant pain prior to surgery. Many of these patients will require escalating doses of pain medications following surgical debridement and grafting. Some will already have developed tolerances to pain medications. So, what do we prescribe to control their pain? More importantly, what can we prescribe and still maintain a level of comfort... Read More.
Clinical Editor: Lawrence Karlock, DPM
| 9,110 reads | 0 comments
Even if a wound appears to be benign, one must obviously be vigilant against the possibility of malignancy. These expert panelists discuss identifying malignant wounds, taking biopsies and when one might consider an amputation. Q: What clinical insights lead you to suspect that a lower extremity wound may have an underlying malignancy? A: M. Joel Morse, DPM, suspects malignancy if a wound does... Read More.
Clinical Editor: Lawrence Karlock, DPM
| 11,951 reads | 0 comments
Patients with venous ulcers can face daunting complications. Accordingly, our expert panelists provide pertinent pearls on diagnosis, compression therapy, debridement and how their patients have fared with vascular surgery procedures. Q: How do you approach/work up the patient with a chronic venous ankle ulcer? Is there any need for venous ultrasound studies? A: Kazu Suzuki, DPM, CWS, says many... Read More.
Clinical Editor: Lawrence Karlock, DPM
| 15,213 reads | 0 comments
While there is not an overwhelming amount of literature on hyperbaric oxygen therapy (HBO), the recent decision by the Centers for Medicare and Medicaid Services (CMS) to cover the use of HBO in treating diabetic foot wounds has fueled new discussions on the potential efficacy of the modality. With this in mind, our panelists discuss their experiences in using HBO, the current literature on the... Read More.
Clinical Editor: Lawrence Karlock, DPM
| 7,729 reads | 0 comments
Plastic and reconstructive surgery techniques can be a significant adjunct for podiatric surgeons in managing diabetic foot wounds and tissue loss. With this in mind, the panelists discuss a variety of techniques (including split-thickness skin grafting and muscle flaps) and indications for chronic ulcers, the neuropathic foot and pressure-induced heel ulcerations. Q: When do you consider... Read More.
Clinical Editor: Lawrence Karlock, DPM
| 6,816 reads | 0 comments
Neuropathic ulcers can be extremely problematic for diabetes patients and podiatrists alike. Exploring the ins and outs of surgical treatment, our expert panelists take a closer look at specific ulcers, helpful techniques, the merits of preoperative vascular testing and postoperative protocols. Q: Do you perform prophylactic diabetic foot surgery? If yes, what are the common types of situations... Read More.
Clinical Editor: Lawrence Karlock, DPM
| 5,877 reads | 0 comments
As Aristidis Veves, MD and Thanh Dinh, DPM, point out, it is well-known that the chronic diabetic foot ulcer is stuck in the inflammation phase of the wound healing cycle. Research studies have shown that non-healing wounds may have specific biochemical imbalances, notes Liza Ovington, PhD. In particular, non-healing wounds have been shown to have excessively high levels of proteolytic enzymes... Read More.
Clinical Editor: Lawrence Karlock, DPM
| 9,404 reads | 0 comments
Ischemic wounds can be challenging for any physician. With this in mind, the panelists discuss key indicators to look for in the history and physical exam, the effectiveness of noninvasive vascular testing and parameters for performing an amputation after bypass surgery. They also explore the treatment possibilities of angioplasty/stenting and the long leg distal bypass. Without further delay,... Read More.
Clinical Editor: Lawrence Karlock, DPM
| 10,598 reads | 0 comments
In a follow-up to the last Q&A column on preventing post-op wounds (see page 16, January issue), our expert panelists have reconvened to discuss the treatment of post-op wounds. They explore treatment approaches to a variety of wounds, ranging from the post-op dehiscence and infected wounds to exposed internal fixation and fracture blisters. Without further delay, here are their thoughts. Q:... Read More.
Clinical Editor: Lawrence Karlock, DPM
| 9,684 reads | 0 comments
Offloading diabetic neuropathic ulcers comes with a unique set of treatment challenges. Some consider total contact casting the gold standard but whether it’s practical in a busy practice is highly debatable. Still, how can one arrive at a solution that will enhance patient compliance? With these issues in mind, our expert panelists share their thoughts and experiences with this topic. Q: How do... Read More.
Clinical Editor: Lawrence Karlock, DPM
| 6,309 reads | 0 comments
Given the potentially serious nature of venous ulcers in the lower extremity, our expert panelists take a closer look at key risk factors and share their treatment approaches to this condition. Drawing from their experience, they also discuss topical treatments, the use of bioengineered skin substitutes and surgical procedures. Q: What risk factors predispose patients to the development of lower... Read More.