The Top 10 Innovations In Podiatry

Author(s): 
Brian McCurdy, Senior Editor

   Dr. Feldman emphasizes that the pedCAT uses 5 to 10 percent of the radiation of a traditional CT scanner, exposing the patient to less cumulative radiation. However, he still urges caution in using any radiation-emitting device on patients. Dr. Feldman will only use the pedCAT on patients with a pathology that he cannot evaluate effectively with plain radiographs. He also uses the modality for weightbearing preoperative planning and to evaluate pathologies that have been historically evaluated via CT.

5. Sensilase PAD-IQ (Vasamed). Skin perfusion pressure (SPP) can be a valuable and efficient indicator of the presence of peripheral arterial disease (PAD). The new and improved iteration of one device for measuring SPP is more portable with advanced analysis techniques.

   The latest generation of the laser-based SPP monitor, the Sensilase PAD-IQ (Vasamed), is “drastically smaller and lighter” at about 15 pounds, notes Kazu Suzuki, DPM, CWS. He notes that physicians can now carry it from room to room or secure it to an intravenous pole.

   Dr. Suzuki says the PAD-IQ has two channels — in comparison to one channel for the previous Sensilase model — that allow one to test both limbs at the same time and reduce the testing time by half. He notes the interface is entirely based on a touch screen so physicians can operate the device without a mouse or keyboard.

   “I have had this new PAD-IQ device for a few weeks and I am quite impressed with its form factor (smaller and lighter),” says Dr. Suzuki, the Medical Director of the Tower Wound Care Center at the Cedars-Sinai Medical Towers. “The simple fact that I can measure two areas at one time also cuts down on the testing time, especially when I am measuring multiple limb levels on complicated vascular patients.”

   Another facet of the PAD-IQ is its “Studycast” cloud computing feature, which enables physicians to send the test results wirelessly to the Vasamed’s Studycast secure Web site, according to Dr. Suzuki. He says that feature allows one to review and interpret the test results, and share them with colleagues for better communication among medical disciplines and building referral bases.

   Dr. Suzuki used the original Sensilase device for seven years and calls it an “absolute necessity for our wound care practice” for monitoring SPP to assess the wound healing potential by measuring the skin capillary blood flow. He says measuring SPP is vital for wound care and surgery planning as well as for diagnosing peripheral arterial disease. Dr. Suzuki emphasizes that skin perfusion pressure is a more accurate and reproducible microcirculatory test in comparison to transcutaneous oximetry monitoring. He also notes that SPP offers a big advantage over the ankle-brachial test as it is not affected by calcified arteries that often occur in patients with diabetes or those on dialysis.

   Dr. Suzuki notes that since the laser Doppler monitor is proprietary, one will need to purchase or lease the unit. However, he notes that since non-invasive vascular tests are fully reimbursable tests with appropriate diagnosis and medical necessity, one should be able to recoup the cost relatively easily. For example, Dr. Suzuki says the PAD-IQ allows one to perform and submit for CPT code 93923 (non-invasive physiologic study of lower-extremity, three levels or measurements with reactive hyperemia). He says this CPT code is listed as 0.45 Work RVU and has a $183.51 facility rate in his Los Angeles area.

Pertinent Insights On A New Topical Gel For Wound Management

6. Excellagen (Cardium Therapeutics). A new topical gel may help foster improved healing in chronic wounds. Excellagen is a fibrillar bovine Type I collagen-based topical gel (2.6%) that could provide adjunctive debridement benefits in non-healing diabetic foot ulcers, according to the product’s manufacturer Cardium Therapeutics.

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