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How To Manage Venous Stasis Ulcers

By Tamara D. Fishman, DPM | 38,581 reads | 1 comments | 05/03/2007

Given the poor healing rates, high recurrence and castly nature of venous stasis ulcerations, this author offers a primer on key clinical signs, helpful insights on compression and wound care modalities, and underscores the importance of appropriate referrals. In the United States, venous stasis ulcers have been estimated to cause the loss of

Managing Ulcers On The Charcot Foot

By Pamela M. Jensen, DPM, and John S. Steinberg, DPM | 31,118 reads | 0 comments | 07/03/2003

Neuropathic osteoarthropathy, or Charcot arthropathy, is a condition associated with a loss of sensory nerve function and concurrent vascular dynamic changes. In the acute setting, Charcot can result in bone and joint deformation and fragmentation. If it is not treated early and aggressively, the collapse of involved joints will cause instability, deformity and subject bony prominences to ulceration and infection. The incidence in the United States and internationally of those with diabetes who have Charcot arthropathy ranges from 7.5 to 13 percent.

Diagnosing Different Types Of Heel Ulcers

Guest Clinical Editor: Tamara D. Fishman, DPM | 45,485 reads | 0 comments | 11/03/2003

When a patient presents with an ulcer on the heel, one must perform an in-depth examination because distinctions among different types of ulcers can be subtle. Prompt, appropriate treatment is essential and it is also critical to assess predisposing risk factors and what can be done to help minimize these risks. With this in mind, let’s take a look at the following case study. A 58-year-old Caucasian male had recently been hospitalized because he fell and broke his right hip. While he was in the hospital, the patient developed the condition on his right heel (as seen in the photo below).

Is Foam More Effective Than Gauze With Negative Pressure Wound Therapy?

Point: Lee C. Rogers, DPM, Counter Point: Michael Miller, DO | 20,198 reads | 0 comments | 06/25/2009

Yes. Lee C. Rogers, DPM cites the evidence from negative pressure wound therapy (NPWT) trials and says the characteristics of NPWT foam facilitate the development of granulation tissue and improved healing in diabetic foot ulcers.

   There is no question that negative pressure wound therapy (NPWT) is a valuable modality in facilitating wound closure. In particular, the use of foam dressings with NPWT has demonstrated success in reducing wound surface size and accelerating the formation of granulation tissue.

Essential Treatment Tips For Decubitus Ulcers

By Farah Siddiqui, DPM, and John Steinberg, DPM, FACFAS | 22,927 reads | 0 comments | 04/21/2011

Given the prevalence and problematic nature of decubitus ulcers in at-risk patients, these authors review proper staging, keys to debridement and other principles for facilitating successful wound closure.

Here one can see a diabetic foot ulcer (DFU). Peripheral arterial disease is cited by the panelists as a key risk factor for the development of these ulcers. The panelists emphasize the importance of a multidisciplinary team in preventing DFUs.

Examining The Evidence For Preventing Diabetic Foot Ulcers

Clinical Editor: Lawrence Karlock, DPM | 21,138 reads | 0 comments | 03/03/2008

When it comes to patients with diabetes and lower extremity ulcers and complications, what does the evidence-based medicine say about high-risk patients and proactive prevention? These panelists examine risk factors for ulcerations, appropriate screening and offer their thoughts on what works and what does not work in terms of prevention.  

Current Concepts In Treating Ischemic Foot Ulcers

Clinical Editor: Lawrence Karlock, DPM | 29,318 reads | 0 comments | 03/03/2007

     When it comes to patients with ischemic foot ulcers, potential complications can be dire. Accordingly, it is important to have a firm grasp on diagnostic studies as well as current and emerging treatment options that may enhance outcomes for patients.      With this in mind, our expert panelists discuss a range of issues related to the ischemic foot.      Q: How do you approach/work up the ischemic foot ulcer patient?      A: David E.

Current Options In Treating Chronic Venous Ulcers

By Michael Baker, DPM, CWS | 10,645 reads | 0 comments | 09/03/2004

As foot and ankle surgeons, we are constantly reminded that we are the ultimate champions of diabetic foot care. However, another emerging problem is chronic venous insufficiency (CVI) ulcerations. While it does not have nearly the potential impact of limb loss one may see with complications from the diabetic foot, there is an increasing incidence of CVI with the continued aging of the population. According to current estimates, CVI affects between 0.1 and 0.3 percent of the total population in the United States. The healthcare industry spends $400 million annually on treating CVI.

How A New Dressing May Enhance Healing Of Heel Ulcers

By Brian McCurdy, Associate Editor | 7,955 reads | 0 comments | 12/03/2003

Ideally, a treatment should be quick and easy to use without sacrificing patient comfort. Negative pressure wound therapy can work well on wounds as it helps to remove exudate and enhance granulation. Continuing to improve upon its VAC therapy, KCI has introduced the new VAC® GranuFoam™ Heel Dressing. Designed just for heel wounds, the dressing has won raves from a few podiatrists for its quality, speed and ease of use. Colleen Schwartz, DPM, introduced the dressing at the American Podiatric Medical Association meeting in August and praises its benefits. Dr.

Key Insights On Offloading Diabetic Neuropathic Ulcers

Kazu Suzuki, DPM, CWS | 12,663 reads | 0 comments | 06/26/2009

   Offloading a wound is a critical component of facilitating optimal outcomes with healing. Accordingly, these expert panelists discuss the use of total contact casting (TCC) to offload diabetic neuropathic wounds as well as the impact of instant total contact casting (iTCC) and other offloading methods.

   Q: As far as offloading devices go for diabetic/neuropathic foot ulcers, do you use total contact casting?