Top Ten Innovations In Podiatric Care
Technology continues to facilitate advances in podiatry that can make a significant difference for patients. Accordingly, this author talks to a variety of podiatric physicians about emerging options in surgery, wound care, orthotic treatment and other modalities.
In this annual look at emerging podiatric technologies and products, the author consults various podiatrists on the benefits of a wound debridement system, an ankle implant, surgical devices, an orthotic casting system, a new method of pathogen detection and more.
1. Qoustic Wound Therapy System™ (Arobella Medical). Ultrasound has been developing over the last few years as a valuable debridement mechanism for various types of lower extremity wounds. An emerging device, the Qoustic Wound Therapy System reportedly provides the benefits of low-frequency ultrasound and accommodates patients who have sensitive wounds.
Although low-frequency ultrasound with saline irrigation has been in existence for several years, the Qoustic system includes a unique “curette” design that focuses the saline in a cone shape, which reduces splashing, according to Kazu Suzuki, DPM, CWS. He notes one can use this product in the exam room or operating room, a key advantage over older ultrasound devices, which are limited to use in the OR. In addition, Dr. Suzuki says the Qoustic is the only available ultrasound device on the market that permits both contact and non-contact ultrasound.
The Qoustic system is indicated for wound debridement of acute and chronic ulcers, burns, diseased and necrotic tissue, according to Arobella Medical, the manufacturer of the device. The company adds that the system is helpful for treating diabetic foot ulcers, pressure ulcers, arterial wounds and other lower extremity wounds. Arobella Medical cites the device’s control over the debridement procedure, saying its domed Qoustic Qurette™ allows volumetric removal of unwanted tissue while focusing ultrasonic energy directly on the area of the wound.
Dr. Suzuki says the Qoustic system offers several advantages over other ultrasonic wound debridement devices. Other ultrasound devices may require expensive, proprietary saline bottles, according to Dr. Suzuki, the Medical Director of Tower Wound Care Center at the Cedars-Sinai Medical Towers in Los Angeles. Some ultrasound devices are too painful for patients who are under local anesthesia so he notes this restricts physicians to using them only in the OR. In addition, Dr. Suzuki notes the Qoustic device is highly effective in preparing the wound bed prior to skin grafting.
“Since the ultrasound wound devices are known to kill all the bacteria and the biofilms on the wound surface, I believe it is becoming the standard of care to use this modality (ultrasound) prior to applying skin graft or skin substitute,” opines Dr. Suzuki.
Dr. Suzuki notes no contraindications to low-frequency ultrasound debridement but does acknowledge potential limitations of the cost of the equipment.
2. Marathon™ Liquid Skin Protectant (Medline Industries). When it comes to protecting chronic wounds from tears and maceration, physicians may want to consider the use of Marathon Liquid Skin Protectant.
Lee C. Rogers, DPM, notes that the product is cyanoacrylate, a superglue-like material, which is novel in the skin preparation/skin barrier arena. As he explains, the cyanoacrylate forms a flexible barrier that is resistant to wound fluid and blood, which prevents maceration.