The Top Ten Innovations In Podiatry
Podiatric physicians continue to gain new tools and technologies to improve lower extremity care. This author gets the input of experts on recent and emerging innovations in areas including surgical advances, wound care and antifungals.
Emerging advances in technology in 2014 include two new antifungals, a device to help detect neuropathy, improved wound dressings, painless harvesting of epidermal skin grafts, a skin substitute, a total ankle implant and a device to augment bone marrow stimulation.
Hyalomatrix® (Anika Therapeutics). An innovative wound dressing utilizes hyaluronic acid to provide a three-dimensional scaffold to promote cellular invasion and capillary growth.
Adam Landsman, DPM, PhD, notes the Hyalomatrix contains a fibrous form of hyaluronic acid bound to a semi-permeable layer of silicone. He says the hyaluronic acid component acts as a biodegradable scaffold for proliferating cells and capillary growth while the silicone membrane preserves moisture and protects the wound.
“In this way, it is a great alternative to the much more expensive products composed of animal collagen and silicone,” says Dr. Landsman, an Assistant Professor of Surgery at Harvard Medical School.
The manufacturer Anika Therapeutics says Hyalomatrix is a bilayered, sterile, flexible wound dressing composed of a non-woven pad made entirely of HYAFF®, a benzyl ester of hyaluronic acid. When the newly formed dermal matrix integrates the HYAFF-based material, the company says a well-vascularized granulation tissue forms to facilitate wound closure via spontaneous re-epithelialization or a suitable dermal layer for skin grafting.
Anika says Hyalomatrix is indicated to help manage the following wounds: partial and full-thickness wounds; second-degree burns; pressure ulcers; venous ulcers; diabetic ulcers; chronic vascular ulcers; tunneled/undetermined wounds; surgical wounds; trauma wounds; and draining wounds.
Dr. Landsman cites “outstanding” preliminary results in the last few months of use, saying he has seen “obvious increases” in the development of granulation tissue after just two weeks of application. Similar to using the more expensive biologics, he says one peels away the silicone layer once separation has occurred.
Dr. Landsman notes one can reapply Hyalomatrix as frequently as twice per week if necessary. Alternatively, if the wound is clean, he says the dressing can stay in place for up to two weeks. Since the dressing can remain in place for an extended period, he does not recommend using it on highly contaminated or infected wounds without first pretreating to bring the infection or contamination under control.
Hydrofera Blue® Ready (Hollister Inc). When managing wound bioburden is a concern, an innovative spin on an established technology might be the answer for physicians. The new Hydrofera Blue Ready foam uses methylene blue and gentian violet to provide broad-spectrum antibacterial protection, according to the manufacturer Hollister Inc.
Eric Lullove, DPM, CWS, says the polyurethane foam can absorb moderate to heavy exudate. He maintains that the new foam dressing does not pull away from the wound and does not lead to maceration.
“For the majority of lower extremity wounds, (Hydrofera Blue Ready is) a great product,” says Dr. Lullove, who is in private practice in Boca Raton, Fla.