Volume 14 - Issue 2 - February, 2002
Commentary: Biology and Treatment of Diabetic Foot Ulcers
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Diabetic foot ulceration (DFU) remains a serious healthcare problem. DFUs can seriously affect a patient’s quality of life with potential grave consequences, including prolonged hospitalization and lower-limb amputation. Furthermore, DFUs can have considerable socioeconomic impact because of the heavy economic burden they place on the health-providing system.
The encouraging news is that during the last two decades, our understanding of the physiology and pathophysiology of wound healing has increased dramatically, and, as a result, advanced treatments based on this knowledge are starti
Emerging Treatments in Diabetic Wound Care
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Introduction
Treatment of diabetic foot ulceration is much more complex than simply putting a dressing over a wound. Diabetic foot ulceration is a significant cause of morbidity and is the most common reason for hospital admission in diabetic patients. Annually, two to three percent of diabetic patients1,2 will develop foot ulcers, and up to 15 percent of diabetic patients will develop chronic ulcers during their lifetimes.3 In those who require lower-limb amputation, 70 to 90 percent will be preceded by a foot ulceration.
Physiology of Wound Healing
The three general
Prevalence of Diabetic Neuropathy and Foot Ulceration: Identification of Potential Risk Factors—A Population-Based Study
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Introduction
There is substantial evidence that diabetic neuropathy (DN) leading to foot ulceration (FU) is associated with increased morbidity and increased risk of mortality. Previous estimates of the prevalence of diabetic peripheral neuropathy vary widely due to the different diagnostic criteria employed and study populations involved.1,2
Since a definition of DN was obtained in the San Antonio Conference3 and a more clinical approach to the diagnosis was suggested later by the Neurodiab subcommittee of the European Association, there have been only a few population-based st
The Choice of Diabetic Foot Ulcer Classification in Relation to the Final Outcome
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Introduction
Diabetes mellitus-related foot ulceration is very common. As a result of neuropathy, peripheral vascular disease, and infection, patients with diabetes are prone to develop diabetic foot problems that may eventually require a lower-extremity amputation. Of all individuals with diabetes mellitus, 15 percent will be affected by ulceration at least once in their lifetime.1,2 The presence of foot ulceration increases the hospitalization duration by 59 percent in people with diabetes mellitus. Because diabetic foot ulceration is a serious problem and because ulcers are heter
Efficacy of Injected Liquid Silicone is Related to Peak Plantar Foot Pressures in the Neuropathic Diabetic Foot
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Introduction
It is well established that increased plantar foot pressure is an important predictive risk factor for the development of diabetic foot ulceration.1,2 High foot pressures usually occur at sites with bony prominence and have been strongly associated with reduced plantar tissue thickness.3 However, it is important to consider that increased plantar pressure and/or thinner padding under the forefoot will only lead to foot ulceration in association with a loss of protective sensation.4 Normal preventative care of diabetic neuropathic patients at risk of foot u
Conservative Management of Diabetic Foot Ulcers Complicated by Osteomyelitis
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Introduction
Foot ulcers in patients with diabetes constitute a growing and costly public health concern. Diabetes is increasing in prevalence, especially in developed nations. In the United States, the prevalence is estimated to be 7.3 percent of adults.1 Foot ulcers in these individuals arise at an incidence of 2.5 percent each year and, unfortunately, may initiate a pathway to amputation and limb loss.2
One adverse consequence of foot ulceration is infection, which becomes limb threatening when there is bone involvement. Repetitive pressures on an ulcer often are rapid
Diagnostic Dilemmas: Bullous Pemphigoid
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Presentation
A 77-year-old Chinese man with a history of Parkinson’s disease presented with a two-month history of blisters on his feet and ankles. He did not have any blisters in his mouth or on his genitalia. His medications included zinc sulfate, vitamin C, multivitamins, bromocriptine (Parlodel), oxybutynin chloride (Ditropan), carbidopa-levodopa (Sinemet), docusate sodium, and iron supplements. He had no family history of blistering disease.
Physical examination revealed a slim, elderly, Asian gentleman. His head, neck, oral mucosa, chest, abdomen, back, upper extremities, and g
Westaim’s NUCRYST to Pursue Pharmaceutical Applications for its Proven Nanotechnology
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NUCRYST Pharmaceuticals Corporation, formerly Westaim Biomedical Corporation, announced that it is pursuing pharmaceutical opportunities for its patented silver nanocrystalline technology—the only nanotechnology of its kind in healthcare applications. NUCRYST Pharmaceuticals is a subsidiary of The Westaim Corporation.
The establishment of NUCRYST’s pharmaceutical research and development laboratory in the company’s new headquarters in Wakefield, Massachusetts, will focus on the development of their proprietary nanotechnology for specific medical conditions. This strategic decision buil
The Physiology of Wound Healing Self-Study CME/CE Monograph—Free of Charge
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The self-study monograph provides information for physicians, podiatrists, physician assistants, nurses, and other healthcare professionals on the cellular and biochemical processes underlying the wound healing cascade and the external and metabolic factors that can hinder as well as enhance the healing process.
To order, call (888) 674-6434 now for a free copy of this exciting learning tool. Ask for The Physiology of Wound Healing self-study monograph and give your name, mailing address, and phone number, so it can be sent to you.
This monograph is supported by an educational grant from
Dermagraft Receives Reimbursement Pass-Through Code
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Advanced Tissue Sciences, Inc. and Smith & Nephew plc announce that Dermagraft® Human Fibroblast-Derived Skin Substitute has received an Ambulatory Payment Classification (APC) pass-through code under the Hospital Outpatient Prospective Payment System from the Centers for Medicare and Medicaid Services.
The pass-through payment code for Dermagraft (C 9201) covers Medicare patients with diabetic foot ulcers treated in a hospital outpatient setting. It became effective January 1, 2002. This will allow each of the Medicare local carriers/fiscal intermediaries to begin developing coverage guid
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