Abstract: 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 […]
Abstract: 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 […]
Abstract: 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 […]
Index: WOUNDS. 2013;25(5):113–120. Abstract: The extracellular matrix (ECM) of the dermis is a critical structural component required for normal wound healing. The ECM, along with its key signaling components, provides the support structure necessary for fibroblasts, immune cells, and keratinocytes. When ECM activity is dysfunctional, the normal wound heal […]
Index: WOUNDS. 2012;24(12):350–355. Abstract: Bullosis diabeticorum (bullous disease of diabetes or diabetic bullae) is a noninflammatory, blistering disease occurring spontaneously in diabetic patients.The bullae are usually located on acral skin surfaces, particularly the feet. While this disease is unique to patients with diabetes, it may mimic other bl […]
Index: WOUNDS. 2012;24(12):339–349. Abstract: Doxycycline is a semisynthetic, chemically modified tetracycline compound that is rapidly absorbed and exerts biological effects independent of its antimicrobial activity. One such effect includes the inhibition of matrix metalloproteinases. Doxycycline has a long history as a collagenase inhibitor. This articl […]
Index: WOUNDS. 2012;24(10):299–307. Abstract: Amniotic membrane has been employed in the treatment of wounds for almost 100 years, beginning with early application of natural amniotic membrane obtained from labor and delivery to various types of burns and wounds. Amniotic membrane is rich in collagen and various growth factors that support the healing proc […]
Index: WOUNDS. 2012;24(6):152–159. Abstract: A total contact cast (TCC) is considered the gold standard for healing diabetic foot ulcers (DFU). Numerous studies have demonstrated the excellent healing success of a TCC; however, its adoption in routine clinical use does not match its success rate. This lack of implementation is due to several factors: Medic […]
Chances are that you have had a patient or two ask for your opinion on barefoot running or minimalist shoes. Accordingly, these panelists share their perspectives on the recent surge of interest in these topics, review pertinent keys to patient assessment and discuss common injuries they have seen. read more
Given the prevalence of onychomycosis and its varied clinical presentation, this author discusses the evolution of diagnostic testing and offers insights on the roles of various modalities in the treatment of severe onychomycosis. read more
Bilobed flaps can preserve tissue and facilitate primary closure in various surgical procedures as the flaps do not require skin grafts and have predictable long-term reproducibility and functional outcomes. Accordingly, this author presents his own experience with bilobed flaps and discusses how they can have an impact in closing lower extremity defects. re […]
In light of an increasing body of research on the effect of orthoses on chronic ankle instability and postural sway, this author discusses essential biomechanical considerations and recommends orthotic prescriptions and modifications to treat unstable ankles. read more
Yes. Citing the literature, enhanced sterility and ease of use, Howard Kimmel, DPM, says human acellular dermal matrices are an effective option for wound care. No. Alexander Reyzelman, DPM, says the role that fibroblasts play in facilitating the healing of chronic wounds is well established whereas questions abound for acellular dermal matrices, which lack […]
Can cryosurgery be an effective alternative treatment for neuromas? This author offers keys to diagnosis, shares pertinent pearls on cryosurgical techniques and emphasizes the benefits of ultrasound injection guidance. read more
Although a recent study concludes that hyperbaric oxygen therapy (HBOT) is not effective for healing diabetic wounds, several physicians note that HBOT does have a benefit as an adjunctive treatment for non-healing diabetic foot ulcers. read more
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These blog publications are not binding and their use should be flexible to accommodate patient needs. Application of this information in a particular situation remains the professional responsibility of the practitioner. The reader, moreover, is urged to check the package insert for each drug and dressing for any change in indications and dosages and for added warnings and precautions.