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Amniotic Membrane: Does It Have Promise For Diabetic Foot Ulcers?

Karen Shum, DPM, and Lee C. Rogers, DPM | 15,803 reads | 2 comments | 05/23/2013

The prevalence of diabetes, estimated at 14 percent in 2010, is projected to increase to 21 percent of adults in the United States by 2050.1 The Centers for Disease Control and Prevention (CDC) has projected that as many as one out of three U.S. adults could have diabetes by 2050 if current trends continue.1

Can Phenytoin Help Heal Diabetic And Venous Ulcers?

Allen Jacobs DPM FACFAS | 9,186 reads | 0 comments | 06/20/2013

Extemporaneous compounding offers the ability to individualize treatment for the specific needs of each patient. Frequently, compounding allows the creation of topical preparations that are otherwise not commercially available. Topical preparations can provide increased concentration within the wound as they have the ability to alter local wound dynamics and chronic wound physiology without systemic modification of the selected agents.1

Emerging Insights On Ex-Fix Offloading For Diabetic Foot Ulcers

William P. Grant, DPM, FACFAS, Lisa M. Grant, and Bryan R. Barbato, BS | 12,757 reads | 0 comments | 03/25/2013

It is well understood that unremitting pressure is a major etiologic factor in both the creation and persistence of diabetic foot ulcers. Sensory neuropathy in combination with autonomic and motor neuropathy readily produces foot deformities with bony prominences and skin lacking normal protective sensibility. Further complicating the problem, alteration in tendon morphology and its function produces increased plantar pressures as well as temporal alteration in the phasic gait cycle that can destroy the protective barrier of the skin beneath the foot.

What The Evidence Reveals About Midfoot Ulcers In Patients With Diabetes

Valerie Schade, DPM, AACFAS | 16,965 reads | 0 comments | 03/25/2013

Given the long-term challenges with conservative care and high recurrence risk associated with diabetic midfoot ulcers, this author examines the literature on surgical procedures including the exostectomy and realignment arthrodesis.

Injectable Silicone: Can It Mitigate Plantar Pedal Pressure?

By Stephanie C. Wu, DPM, MS | 27,741 reads | 0 comments | 09/03/2008

Ambulation exposes the foot to a collaboration of focal pressure and repetitive stress, and ground reaction forces generated in response to weightbearing activities are the commonly responsible stressors.1 The portion of the foot in contact with the ground varies during the stance phase of gait. Accordingly, the site of ground reaction force application varies, generally progressing from the heel at first contact to the hallux at toe-off.2

Expert Pointers On Negative Pressure Wound Therapy

Clinical Editor: Lawrence Karlock, DPM | 31,545 reads | 0 comments | 07/03/2007

Given the increasing use of negative pressure wound therapy (NPWT) to spur wound healing, our expert panelists return for the second part of this Q&A discussion on NPWT (see “Inside Insights On Negative Pressure Wound Therapy,” page 24, May issue). They offer specific pearls on the use of NPWT, how to combine the modality with skin grafts and silver dressings, and tips for avoiding wound maceration. Q: Do you have any pearls for using negative pressure wound therapy (NPWT)? A: Eric Travis, DPM, utilizes VAC therapy (KCI) mostly at 125 mmHg of continuous suction.

Is Shear The New Peak Plantar Pressure?

Adam Landsman, DPM, PhD, FACFAS | 13,235 reads | 0 comments | 05/21/2012

In a provocative discussion of the potential impact of shear forces in the high-risk diabetic foot, this author offers pertinent biomechanical insights and offers suggestions for minimizing the detrimental effects of shear forces in this patient population.

Understanding How The Achilles Tendon Affects Plantar Pressure

Eleanor Wilson, DPM | 21,236 reads | 0 comments | 04/23/2009

   Approximately 23.6 million people in the United States have diabetes, according to the 2007 statistics from the American Diabetes Association.1 Many of these patients have an associated comorbidity of obesity and, all too often, Achilles tendon contracture.

Mastering Difficult Heel Ulcers

By Robert J. Snyder, DPM, CWS, and Heather Perrigo, RN | 39,319 reads | 0 comments | 11/03/2002

Pressure ulcer disease represents a significant medical problem both nationally and internationally. Approximately 1.7 million people in the United States develop these maladies at an annual cost of between $2.2 billion and $3.6 billion.1 With the population aging, assisted living and nursing facilities flourishing and obesity creating catastrophic increases in diabetes and other diseases, it is likely the number of ulcerations will continue to increase.

Inside Insights On Negative Pressure Wound Therapy

Clinical Editor: Lawrence Karlock, DPM | 13,437 reads | 0 comments | 05/03/2007

Negative pressure wound therapy (NPWT) can have a positive effect on wound healing. These panelists detail what types of wounds can benefit from the technology, when to consider negative pressure and how various NPWT devices compare to one another.

Q:

What has been your general impression and experience with using negative pressure wound therapy for lower extremity wounds?