Cath Lab Digest

Podiatric technology continues to advance and the profession has seen recent innovations in areas such as wound care, surgery and the diabetic foot. Experts in various aspects of podiatry provide insights on acellular dermal matrices, a hammertoe implant, a diabetic insole and other podiatric advances.

Podiatric physicians continue to reap the benefits of improved technologies. In our annual review of the latest innovations in the field of podiatry, there are products that allow enhanced efficiency in the OR, improved patient adherence and more timely delivery of appropriate antibiotic medications. Certainly, the hope for any of these innovations is to facilitate better treatment outcomes for patients. Without further delay, here are the latest innovations.

   1. Oasis^® Ultra Tri-Layer Matrix (Healthpoint Biotherapeutics). A new version of an extracellular matrix, the Oasis Ultra, now contains three layers of porcine small intestinal submucosa (SIS). The manufacturer, Healthpoint Biotherapeutics, notes the three layers incorporate increased structure into chronic and difficult to heal wounds. The company notes the three layers are 300 microns thick, three times the thickness of single-layer Oasis.

   Gary Rothenberg, DPM, recently started using Oasis Ultra and cites good success. He has used single layer Oasis for years but says the tri-layer product has the advantages of improved thickness and durability for use in deeper wounds in comparison to the single layer version.

   Dr. Rothenberg says Oasis Ultra also has the advantages of simple application and a longer shelf life over competitors such as Apligraf (Organogenesis), Dermgraft (Advanced BioHealing), MatriStem (Medline Industries), Graftjacket (KCI) and Integra (Integra Life Sciences). He notes that Oasis is pre-fenestrated and requires no thawing, major rehydration or suturing. As Dr. Rothenberg notes, one just places the extracellular matrix on the wound, moistens it with saline and secures with Steri Strips.

   “I see it as a simple, user-friendly product in the category,” says Dr. Rothenberg, the Director of Residency Training and an Attending Podiatrist with the Miami Veterans Affairs Healthcare System.

   The only potential downside, notes Dr. Rothenberg, is that the Oasis Ultra comes in fairly large sizes of 7 x 10 cm and 7 x 20 cm, and one must purchase it in boxes of five. He says the 7 x 10 size provides enough product for about four applications of the “typical” diabetic foot ulcer so he has applied the product and then had to assign the piece to a specific patient and keep track of it from week to week. However, Dr. Rothenberg says this is a minor drawback.

   Healthpoint Biotherapeutics notes that Oasis Ultra is indicated for surgical wounds, partial- and full-thickness wounds, traumatic wounds (including second degree burns), venous ulcers, chronic vascular ulcers, diabetic and pressure ulcers and draining wounds. Dr. Rothenberg cautions against using Oasis Ultra in patients with an allergy to porcine products or those with an active infection. In addition, Healthpoint Biotherapeutics notes the product is not indicated for the treatment of third-degree burns.

   Dr. Rothenberg is looking forward to gaining more clinical experience with the product and seeing more clinical evidence on its efficacy.

A More Portable, Patient-Friendly Version Of NPWT

2. VAC Via^™ (KCI). When it comes to negative pressure wound therapy (NPWT), some patients may complain that the NPWT devices are too large, loud and conspicuous. The portable, quiet VAC Via may obviate such concerns and make for a more pleasant patient experience.