I had a great discussion with Dr. John Macdonald the Secretariat of the World Alliance for Wound and Lymphedema Care (WAWLC) . John is an amazing individual who was one of the first physicians on the ground in Haiti (He ran the operation through the University of Miami). John and his friends have since gone on to provide country wide wound care initiatives for any third world nation that is requesting the assistance of the WAWLC. Please support John and the WAWLC’s mission to care for those less fortunate with wounds or lymphedema through out the world. If you get a chance please take a look at their website www.wawlc.org
Wounds Magazine Feed- Chest Wall Defect With an Extensively Encroached Heart and Severely Impaired Cardiac FunctionAbstract: A chest wall defect that penetrates deep into the heart is rare, but life threatening. Reconstructing a defect such as this presents challenges regarding timing and surgical approach. The patient in the present case had a chest wall defect with an extensively encroached heart and severely impaired cardiac function as a result of radiation injury af […]
- Use of Equine Derived Pericardium as a Biological Cover To Promote Closure of a Wound With Associated Scleroderma and Raynaud’sAbstract: A 39-year-old man with previously undiagnosed scleroderma was admitted to the UCSD Medical Center with bilateral, limb-threatening necrotic lower extremity ulcers extending to underlying fascia and muscle. Rather than amputate the extremities, the patient requested alternative treatment and underwent extensive tissue debridement followed by placeme […]
- Daptomycin for the Treatment of Osteomyelitis Associated With a Diabetic Foot UlcerAbstract: This report describes a case of Staphylococcus aureus osteomyelitis associated with a chronic foot ulcer that was successfully treated with surgical debridement and 6 weeks of daptomycin therapy. Daptomycin was chosen because of its excellent activity against the causative organism and the patient’s history of penicillin allergy. Its tolerability a […]
- Chest Wall Defect With an Extensively Encroached Heart and Severely Impaired Cardiac Function
- Wounds Research Review
- Podiatry Today Feed
- Does Patient Age Influence First Ray Procedure Selection?These authors offer a closer look at hallux abducto valgus and the impact of age on treatment decisions in adolescents and elderly patients. read more
- Performing A Tibio-Talo Calcaneal Fusion After Two Post-ORIF NonunionsThis author discusses using a tibio-talo calcaneal fusion with an intramedullary rod in a distal tibia-fibula fracture in a patient who had sustained two nonunions following open reduction internal fixation. read more
- Current And Emerging Insights On Hammertoe CorrectionGiven the risks and patient concerns associated with K-wire fixation, these authors discuss the use of emerging hammertoe implants, absorbable pins and cannulated screws, and share a couple of illuminating case studies. read more
- A Guide To Compression Dressings For Venous UlcersGiven the relatively common incidence of venous insufficiency and the high likelihood of recurrence with venous leg ulcers, these authors offer a thorough review of the literature and share their insights on compression modalities ranging from inelastic (short stretch) bandages to intermittent pneumatic compression therapy. read more
- Alternatives In Fixation For Osteoporotic BoneGiven the decreased bone mineral density and poorer bone healing potential in people with osteoporosis, achieving adequate fixation can be challenging for osteotomies or arthrodesis procedures in this patient population. Accordingly, these authors review the literature and assess a range of fixation options including traditional plate fixation, cannulated sc […]
- Recognizing And Treating Lower Extremity GoutGiven the increased prevalence of gout and how gout affects the lower extremity, the author discusses current concepts in diagnosis and treatment, and provides an illuminating case study. read more
- Understanding The Biomechanical Effects Of The Evans Calcaneal OsteotomyReviewing the evolution of the Evans calcaneal osteotomy, this author discusses the impact on biomechanics, shares insights from the literature on osteotomy placement and bone graft size, and offers pearls on minimizing the risk of common complications. read more
- Clarifying The Scope Of Practice In TexasAs the President of the Texas Podiatric Medical Association (TPMA), I want to respond to your December 2011 cover story, “Scope of Practice Update: Where Things Stand,” as it relates to Texas. I hope to clarify some misinformation and inaccurate facts that could have a negative effect on Texas if left unchallenged. read more
- February 2012The American Medical Association (AMA) is opposing the Conditions of Participation of the Centers for Medicare and Medicaid (CMS) that would allow podiatrists to hold leadership positions at hospitals. read more
- Does Patient Age Influence First Ray Procedure Selection?
Support the World Alliance for Wound and Lymphedema care
April 22, 2011 — Matthew Livingston R.N. C.W.S.Wound Care Tool Kit – Drawtex
April 19, 2011 — Matthew Livingston R.N. C.W.S.Drawtex (SteadMed) is a new find as a hydroconductive debridement agent. I was able to see an average reduction in slough of up to 75% in the eight patients I have tried it on so far. The assumed mode of action is through the dressings ability to forcefully remove drainage (up to 150cc/hr) and content from the wound into the dressing. The force of the fluid transferred into the hydroconductive dressing is able to cleave the denuded collagen that bonds the necrotic tissue from the healthy tissue. The advantage of hydroconductive debridement is that it is a top down debridement tool that can debride over a large surface area (versus the peripherial wound area such as side down debridement agents i.e. Santyl Collagenase).
Indications:
Drawtex works well with wounds with moderate to large drainage, Reoccurring slough, Adherent slough, Consolidated slough with is difficult to remove with curettage and as an alternative for patients who have pain with sharps debridement.
Author notes:
Drawtex is also useful for controlling Biofilm as noted in the (Randy Wilcott Poster which won first place at the SAWC Spring, 2011 Conference).
The dressing will not degrade in the wound and will continue to pull fluid from high draining cavities, so it is very useful with deep narrow or wide tunnels (Were alginates fail).
Hydroconductive Debridement a new Perspective in Wound Debridement
March 8, 2011 — Matthew Livingston R.N. C.W.S.I have long been looking for what to do once we lost Panafil and Accuzyme. Currently, many clinicians have been using Santyl as the default wound debridement agent. We know that Santyl has a place in the scope of debridement, but it in itself has limitations. Needless to say, I have found what we may have been looking for as a wound debridement agent. I recently had the opportunity to finish a case study with a product that provides what I have been looking for as a debridement agent. I will be submitted a poster on a Hydroconductive Debridement dressing called Drawtex (SteadMed) at the Spring 2011 SAWC . The numbers (in terms of reduction of avascular tissue) were very promising. This case study series included a average (with 8 cases) percentage reduction in the total slough and necrosis of 36% at week one, 52% at week two, and 72% at week three. Please note that no other types of debridement were utilized during this study. The study also noted an average percentage reduction in wound area of 15% at week one, 35% at week two, and 47% at week three.
Disclosure: the author receives no financial incentives from SteadMed.
University of Texas Wound Classification System of Diabetic Foot Ulcers
December 19, 2010 — Matthew Livingston R.N. C.W.S.University of Texas Wound Classification System of Diabetic Foot Ulcers
Grade I-A: non-infected, non-ischemic superficial ulceration
Grade I-B: infected, non-ischemic superficial ulceration
Grade I-C: ischemic, non-infected superficial ulceration
Grade I-D: ischemic and infected superficial ulceration
Grade II-A: non-infected, non-ischemic ulcer that penetrates to capsule or bone
Grade II-B: infected, non-ischemic ulcer that penetrates to capsule or bone
Grade II-C: ischemic, non-infected ulcer that penetrates to capsule or bone
Grade II-D: ischemic and infected ulcer that penetrates to capsule or bone
Grade III-A: non-infected, non-ischemic ulcer that penetrates to bone or a deep abscess
Grade III-B: infected, non-ischemic ulcer that penetrates to bone or a deep abscess
Grade III-C: ischemic, non-infected ulcer that penetrates to bone or a deep abscess
Grade III-D: ischemic and infected ulcer that penetrates to bone or a deep abscess
Lavery LA, Armstrong DG, Vela SA, Quebedeaux TL, Fleischli JG. Practical criteria for screening patients at high risk for diabetic foot ulceration. Arch Intern Med. 1998 Jan 26;158(2):157-62.
Matthew Livingston R.N. C.W.S.
