Cath Lab Digest

   He notes that ordinary wound dressings address a single moisture condition. One may use absorbent materials or gauze on a wet, exudating wound whereas wet dressings such as hydrogels are effective on a dry wound. However, Dr. DiDomenico notes that complex wounds often contain areas of both excess moisture and dry tissue, and TheraGauze controls moisture at the wound interface.

    “From a patient’s perspective, there is no alternative to TheraGauze,” maintains Dr. DiDomenico.

Can A Laser Provide Effective Onychomycosis Treatment?

   6. Noveon® (Nomir Medical Technologies). “With all of the current antifungal drugs, both topical and oral, having gone generic and a number of notable failures being reported in new drug development, medical device companies are developing innovative ways to treat onychomycosis,” notes Warren Joseph, DPM.

   One such innovation is the Noveon laser (Nomir Medical Technologies), says Dr. Joseph. Unlike high-powered lasers that create a “thermal or ablative killing” of fungal and bacterial cells, the Noveon employs two discrete near-infrared wavelengths (870 nm and 930 nm) to kill the organisms, according to Dr. Joseph. He points out that the Noveon laser uses a photo-inactivation effect, which occurs at energy levels and temperatures that are low enough to preserve healthy tissue. As Dr. Joseph notes, this effect is not present in ablative lasers such as the Nd:YAG or ultraviolet devices currently under investigation.

   Nomir Medical Technologies notes that the Noveon laser has demonstrated in trials that it is efficacious in treating onychomycosis without any thermal effects. One trial showed that 76 percent of toes showed improvement of onychomycosis and 74 percent of toes demonstrated a significant decrease in positive cultures after two treatments with the Noveon laser, according to the company.

   Dr. Joseph says the company has completed an IRB approved pivotal trial and submitted this to the Food and Drug Administration (FDA) to obtain a specific indication for treating onychomycosis. If the FDA grants approval, the Noveon laser will be the first device to have achieved this specific level of FDA clearance, points out Dr. Joseph, who is affiliated with the Roxborough Memorial Hospital in Philadelphia and the Coatesville Veterans Affairs Medical Center in Coatesville, Pa.

   The FDA has previously approved Noveon for use in contact and non-contact surgical procedures of the skin, subcutaneous tissues, and nasal passages in dermatology, podiatry, plastic surgery and otolaryngology.

   Nomir Medical Technologies also cites pilot studies looking at the ability of the Noveon laser to eliminate methicillin-resistant Staphylococcus aureus (MRSA) in the nose.

    “Although more studies need to be undertaken, this selective photo-damage effect against prokaryotic and fungal pathogens may eventually prove useful in the management of lower extremity bacterial infections,” says Dr. Joseph, a consultant to Nomir Medical Technologies.

   The company says the laser uses optical energy to eliminate biofilm, bacteria and fungi and facilitate the recovery of tissue with fewer side effects than with pharmaceutical treatments. Nomir Medical Technologies notes that the laser is gentle due to its photobiologic mechanism of action, which does not produce heat.

Pertinent Pearls On A New Pediatric Orthosis

   7. P3 Kiddythotic (ProLab Orthotics). With the P3 Kiddythotic, podiatrists can determine orthotic sizes themselves rather than relying on a lab.

   Ronald Valmassy, DPM, has been using the device and feels it is “the best of any of the prefabricated devices” that he has ever used. He notes the orthosis can control mild to moderate abnormal foot pronation in pediatric patients.