Dear Readers:
  Healthy feet help us preserve our independence, earn our livelihood, and participate actively in our social environment. A foot ulcer can isolate and depress the individual who suffers it while increasing risk of amputation, infection, or mortality. Healing foot ulcers quickly helps limit the costs and burden of care and keeps patients active as contributing members of family and society. Most foot ulcers will decrease in area by at least 50% in 4 weeks and proceed to complete healing by 12 weeks^1,2 when their growth factor-rich, enzyme-laden fluid is sealed over the wound, cause(s) of injury stopped, and devitalized tissue removed.¹

Dear Editor:

  In June 2012, (WOUNDS. 2012;24(6):152–159), an article I authored regarding the clinical and economic benefits of healing diabetic foot ulcers (DFU) with total contact casts (TCC) was published. Since the time of publication, I have received feedback regarding a couple of points that require clarification.

Index: WOUNDS. 2012;24(8):215–226.

  Abstract: Venous ulcers are prevalent, challenging wounds; their incidence is rising with the increasing age of the general population. Physical modalities often are used to help heal these chronic wounds. A prospective study was conducted to investigate the application of high-voltage stimulation (HVS), ultrasound therapy (US), low-level laser therapy (LLLT, 810 nm, 65 mW, 4 J/cm²), and compression therapy (CT), with and without surgical intervention; along with standard of care comprising drug therapy (micronized flavonoid fraction in two 500-mg tablets once daily) and wet dressings of 0.9% sodium chloride on venous leg ulcer healing. Methods. The 305-patient study was conducted between 1994 and 2008 among persons with venous ulcers in 3 facilities in Poland. After surgery involving crossectomy, partial [short] stripping of the greater or short saphenous vein, local phlebectomy, and ligation of insufficient perforators, 4 groups of patients were treated with the standard of care drug/dressing therapy and HVS, US, LLLT, or CT, and 1 group received the drug/dressing therapy only. Four non-surgical groups received HVS, US, LLLT, or CT and drug/dressing therapy, and 1 group received drug/dressing therapy only.

Index: WOUNDS. 2012;24(8):227–233.

  Abstract: Purpose. In this preliminary study, gauze-based negative pressure wound therapy (NPWT) was used to accelerate granulation tissue formation and promote closure in a number of wound types. The authors aimed to evaluate the efficacy of gauze-based NPWT using the Chariker-Jeter technique for wounds requiring delayed closure. Methods. A retrospective review was conducted of 50 patients with wounds not suitable for immediate primary closure. After initial irrigation, debridement, and antibiotic therapy, Chariker-Jeter technique NPWT was used and dressings were changed at 24- to 48-hour intervals before secondary closure or primary closure. In addition, a 4-point category scoring system (severe, moderate, mild, and none) was used to evaluate pain. Semi-quantitative data also were obtained. Results. Wound size decreased considerably, granulation tissue formation was accelerated, and exudate was reduced and removed by the end of the treatment.