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: Medicare’s payment structure, lack of clinical training, and a variety of patient factors. These factors have reduced clinicians’ use of TCC to approximately 25% of DFU. The aim of this review was to analyze and demonstrate common scenarios for outpatient wound centers where a TCC may be beneficial to both patients and hospital systems, and to expand its usage to more closely reflect its healing success rate.

Index: WOUNDS. 2012;24(6):168–177.

  Abstract: The aim of this retrospective study was to identify risk factors related to unsuccessful treatment and complications with negative pressure wound therapy (NPWT). Methods. A consecutive series of patients treated with NPWT for wounds of various etiologies (n = 87) from 2005–2007 at a general hospital in a large city (Stockholm, Sweden) were assessed for risk for unsuccessful treatment and complications associated with NPWT. Results. Twenty-nine percent of the patients treated with NPWT had unsuccessful treatment results. The strongest risk factors associated with unsuccessful treatment were pressure ulcers (OR 4.6) or a positive culture for Staphylococci (OR 3.4).

Dear Readers:

  One to 2% of individuals with peripheral arterial disease experience its most severe stage, critical limb ischemia (CLI). Within 1 year after an episode of CLI, 25% will undergo a major amputation.¹ Ischemic ulcers associated with CLI are more likely to heal if distal bypass surgery increases skin perfusion pressure to at least 35 mmHg.² If bypass surgery is ineffective³ or no longer suitable, there are limited options for achieving ischemic ulcer healing, improving walking time and distance, limiting CLI-related pain, or delaying amputation or death. Research exploring autologous mononuclear bone marrow stem cells (ABMC),¹ stents,⁴ intermittent pneumatic compression,⁵ gene therapy,^6,7 or other options for improving CLI healing, pain, amputation, or mortality outcomes, have met with varying success.

2012 Corporate Sponsors

  The Association for the Advancement of Wound Care expresses gratitude and deep appreciation to the following companies for their generous financial support in 2012. These companies are not only AAWC Members, but have also contributed large amounts of funding to support AAWC initiatives.