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.
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.
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.
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.
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.
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.
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.
When is advanced imaging necessary for guiding one’s decision-making on the treatment of a lower-extremity wound? How reliable are radiographs when clinicians suspect osteomyelitis? Should you employ magnetic resonance imaging? Does nuclear medicine imaging have particular value in managing wounds? Our expert panelists tackle these questions and more in the following discussion... Read More.
While there is quite an array of choices when it comes to choosing appropriate wound care modalities for lower-extremity wounds, there is not, as one panelist points out, a lot of published evidence for guidance. With this in mind, our expert panelists discuss a variety of wound care scenarios and how their clinical experience guides their decision-making on dressings and... Read More.
Do growth factors improve the rate of wound healing? When is it appropriate to use them on chronic wounds? Is the cost of growth factor modalities worth the results? Our expert panelists answer these key questions, share their experiences and ponder the future of these modalities with their discussion about the efficacy of growth factors in chronic wound care. Without further... Read More.
Assessing and treating infected diabetic foot wounds can be challenging. Providing timely treatment is essential given the potential complications of diabetic foot infections but the rise in antibiotic resistance is a key issue to consider. With this in mind, our expert panelists discuss a variety of issues, ranging from empiric antibiotic selection and MRSA infected wounds to their approach in... Read More.
Whether it is used as a topical ingredient or a dressing ingredient, the use of silver in treating wounds has been around for quite some time. Silver has an array of beneficial effects in promoting healing. Given the potential of silver in the wound care arena, our expert panelists take a closer look at the history of silver in wound care, key indications and their experience... Read More.