Dear Readers: To heal a chronic wound, one diagnoses and alleviates the cause of tissue damage then debrides necrotic tissue and provides an appropriately moist environment for healing.¹ Without effective debridement, necrotic tissue may impede healing² or act as a foreign body or a focus for microbial proliferation. Clarity is emerging on clinical efficacy of debriding modalities for chronic wounds. For example, a systematic review of debridement efficacy reported that hydrogels are the only debridement category with randomized, controlled trial evide

Telemedicine consultations are introduced to enhance communications between “specialist” and “primary care” providers. In the case of problematic wounds frequently affecting the elderly, frail, and non- or poorly-ambulatory patients and those individuals with poor health, telemedicine not only increases access to specialists for patients in rural settings but also facilitates communication in urban settings, reducing costly, emotionally and physically stressful transportation and shortening the time needed for implementation of the management plan with or without sur

The incidence of neurotropic ulcers is reported to affect between 4% and 6% of the diabetic population and is associated with significant morbidity.¹ It has been reported that 85% of lower leg amputations initially present as a foot ulceration.¹ Complicating the initial clinical presentation of the ulcer is the extent and degree of pathology involved. The sensory deprivation and lack of pain associated with these ulcers causes the initial clinical presentation to include significant tissue necrosis requiring extensive surgical intervention. Deep-seated abscesses with e