The Top Ten Innovations In Podiatry

Author(s): 
Brian McCurdy, Senior Editor

   Tracey Vlahovic, DPM, has been using Onmel since last March. She says the once daily dosing of Onmel is a key advantage as it is more convenient for patients than pulse dosing, which is generally done with the generic oral itraconazole.

   Dr. Vlahovic, an Associate Professor and J. Stanley and Pearl Landau Fellow at the Temple University School of Podiatric Medicine, does note that Onmel carries the same potential for drug interactions (with drugs such as lovastatin and simvastatin) as other formulations of itraconazole.

   In regard to contraindications for Onmel, Merz Pharmaceuticals notes the drug is contraindicated in pregnant patients, patients contemplating pregnancy and patients with evidence of ventricular dysfunction such as congestive heart failure or a history of congestive heart failure.

Cidacin (Pedicis Research). A new antifungal solution may get at the heart of tinea pedis. Cidacin can relieve the itching, burning, scaling and cracking that come with fungal infections, according to the manufacturer Pedicis Research.

   Nicholas Romansky, DPM, cites Cidacin as innovative as it combines tolnaftate with dimethyl sulfoxide, which is well documented to penetrate the nail. He notes that most topical antifungals cannot penetrate the nail bed and the nail’s deeper layers where the fungus resides and as a consequence, the infection remains active and is never fully eradicated.

   “Cidacin, on the other hand, has the ability to penetrate because the dimethyl sulfoxide provides the transport to the deeper levels of the nail bed,” says Dr. Romansky, who is in private practice in Media and Phoenixville, Pa. “Cidacin is really the only product to my knowledge that employs a logical solution to this problem and the proof is in the clinical results I have been observing.”

   Dr. Romansky, who has done unpaid product development for the product, has been using Cidacin for approximately six months and notes he has seen “clear nails in as short as four months.”

Key Insights On Emerging Wound Care Products

Endoform (Hollister Wound Care). An emerging extracellular matrix may be beneficial in treating a variety of acute and chronic wounds.

   Endoform is indicated for partial and full thickness wounds, diabetic ulcers, venous ulcers, pressure ulcers and chronic vascular ulcers. The exclusive distributor Hollister Wound Care notes that the Endoform dermal template contains a naturally derived ovine collagen extracellular matrix that is terminally sterilized. The company notes that the ovine origin may be more culturally acceptable than other animal-derived sources.

   Hollister adds that the dressing contains 90 percent native, intact collagen and 10 percent extracellular matrix components. Matthew Garoufalis, DPM, FASPS, cites “very good results” after nine months of using the Endoform. He notes that the product also contains elastin, fibronectin, laminin and glycosaminoglycans. He also cites the product’s unique structure with one side being a dense, contoured matrix and the other side being an open, smooth matrix.

   Endoform also facilitates spectrum reduction of matrix metalloproteinases (MMPs) and its dermal template retains the structure and function of the patient’s native extracellular matrix, notes the company. One may reapply the dressing once a week in comparison to collagen dressings that one must change more frequently. Hollister says the use of Endoform accordingly reduces cost and inconvenience for patients.

   “It is a very robust product with good elasticity and high tensile strength,” notes Dr. Garoufalis, the President of the American Podiatric Medical Association. “It works very well in reducing MMP activity in the wound and yet is very, very cost-effective to use through weekly applications.”

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