The Top Ten Innovations In Podiatry
Kazu Suzuki, DPM, CWS, points out that PriMatrix Ag is the only skin substitute on the market today with built-in antimicrobial ionic silver. As with any other silver-based products, he says ionic silver offers broad spectrum antimicrobial activity, covering both gram positive and negative organisms as well as resistant bacteria such as methicillin-resistant Staph aureus (MRSA) and vancomycin-resistant Enterococcus (VRE). Dr. Suzuki has been using PriMatrix Ag on diabetic foot ulcers, venous leg ulcers and surgical wounds. Dr. Suzuki notes the modality’s ionic silver prevents wound infection while the graft is incorporating within the healing wound.
“I found it to be highly useful in closing ‘difficult-to-heal’ wounds and chronic wounds that did not respond to basic wound care, consisting of sharp debridement and appropriate dressing application,” says Dr. Suzuki, the Medical Director of the Tower Wound Care Center at the Cedars-Sinai Medical Towers.
PriMatrix Ag is unique since it is rich in type 3 collagen, notes Dr. Suzuki. He emphasizes that type 3 collagen is the active collagen found in developing and healing tissues.
The scaffold comes in various sizes and in a dehydrated form with a three-year shelf life. Dr. Suzuki adds that it is pre-meshed or fenestrated, which simplifies the application process. He notes that the PriMatrix Ag has a good tensile strength so one can suture it. Dr. Suzuki also points out that he often uses Mepitel (Molnlycke Health Care) or Steri-Strips (3M) to secure PriMatrix Ag over the wound.
The manufacturer TEI Biosciences notes that the proprietary manufacturing process for PriMatrix Ag preserves the natural dermal collagen fibers’ beneficial properties, generating a tissue matrix that is free of contaminants, artificial chemical crosslinks and denatured proteins. When one applies the modality to the wound, the scaffold’s purity minimizes detrimental foreign body inflammatory responses, according to the company.
Dr. Suzuki adds that Medicare and other insurance companies reimburse PriMatrix Ag with the Q4110 code and as a “high-tier” skin substitute product. He says the application codes are the CPT 15271-15278 series for “application of skin substitute graft.”
The product’s indications include pressure, diabetic and venous ulcers as well as second-degree burns, surgical wounds and traumatic wounds, according to Dr. Suzuki. He points out that these are much broader indications than the other skin substitutes, which are often limited to either diabetic foot ulcers and/or venous leg ulcers.
A New Advance In Detecting Diabetic Peripheral Neuropathy?
Electronic Tuning Fork (O’Brien Medical). Given the urgency of preventing limb loss in patients with diabetes, an emerging diagnostic device could prove to be beneficial in terms of prevention.
The 128-Hz Electronic Tuning Fork can reportedly detect patients at risk for diabetic neuropathy and limb loss, according to the manufacturer O’Brien Medical. The company says the new fork is an improvement over handheld tuning forks, which have limitations in terms of reproducibility and quantification of results. O’Brien Medical notes the Electronic Tuning Fork is a modern digital instrument calibrated to offer standardized, quantifiable results with improved accuracy and reproducibility. It says the device should be available for purchase late this year.
Tammer Elmarsafi, DPM, first used the Electronic Tuning Fork in January 2014. He began using it exclusively in his clinics but after reaching 30 patients, he started to use it for in-patient consultations and admissions as well.