The Top 10 Innovations In Podiatry

Brian McCurdy, Senior Editor

   Arthur Tallis, DPM, says the product’s full-length collagen molecules are in their natural, fibrillar form, and are formulated in a unique physiologic buffer that ensures maintenance of the collagen molecule’s structure and function. Dr. Tallis, a Fellow of the American College of Foot and Ankle Surgeons and the American Professional Wound Care Association, was involved in Phase 1 and Phase 2b diabetic ulcer trials for Cardium Therapeutics.

   Dr. Tallis has applied Excellagen following surgical debridement in the presence of blood cells and platelets. He notes that Excellagen activates human platelets, triggering the release of platelet-derived growth factors (PDGF).

   Dr. Tallis also notes that Excellagen can save time for the physician and patient as dressing changes are required only once a week. He notes additional advantages of Excellagen are that no thawing or mixing of components is required prior to use. Dr. Tallis adds that one can easily apply the formulation to wounds of all sizes and shapes, and the product achieves complete, even wound coverage without dripping. He says 0.5 cc of the collagen can treat a wound up to 5 cm2 in area.

   As Excellagen contains bovine collagen, Dr. Tallis cautions that it is contraindicated in patients who have a known sensitivity to products of bovine origin. Excellagen requires refrigerated storage and he says one must allow some time for the product to achieve room temperature before applying in order for the product flowability to be at its best. The shelf life is 18 months.

Getting Better Patient Adherence With A Topical Antifungal

7. Naftin 2% cream (Merz Pharmaceuticals). An improved formulation of a topical antifungal may be beneficial for patients with tinea pedis.

   Patients used the older Naftin 1% (naftifine) formulation twice a day for four weeks. Tracey Vlahovic, DPM, says patients can now use the 2% Naftin once daily for two weeks. She cites the advantage of a shorter treatment time, noting that it will likely facilitate more adherence in patients.

   Manufacturer Merz Pharmaceuticals notes that Naftin 2% is indicated for interdigital tinea pedis, tinea cruris and tinea corporis caused by Trichophyton rubrum.

   Dr. Vlahovic, an Associate Professor and J. Stanley and Pearl Landau Fellow at the Temple University School of Podiatric Medicine in Philadelphia, was involved in the product’s clinical trials and has used it for patients since the recent launch of the product.

What You Should Know About A New Bone Graft

8. Augmatrix (Biomimetics Therapeutics). A new orthobiologic technology may be a useful tool for filling bone voids in the lower extremity.

   Augmatrix is approved for use in combination with autogenous bone marrow, notes Peter Blume, DPM, FACFAS. He says the product is composed of synthetic carbonated apatite and bovine type I collagen in a 55:45 ratio (w/w). The manufacturer Biomimetics Therapeutics notes the carbonated apatite component closely resembles the mineral phase of bone and Augmatrix granules provide an enhanced osteoconductive scaffold that supports bone remodeling. The carbonated apatite disperses throughout the collagen matrix and the entire construct is 80 percent porous, which Dr. Blume says allows for absorption of bone marrow aspirate and stem cell attachment.

   “Augmatrix is an exceptional osteoconductive graft with osteogenic potential (provided by autogenous stem cells) and an innovative option for bone repair,” says Dr. Blume, an Assistant Clinical Professor of Surgery, Anesthesia and Orthopedics and Rehabilitation at the Yale School of Medicine. “As an off-the-shelf product, Augmatrix represents a cost-effective alternative to autograft that spares patients additional pain and morbidity from a bone graft harvest site.”

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