February, 2005

Dear Readers,

In Evidence Corner, Dr. Laura Bolton reviews 2 articles addressing the safety and efficacy of silver compounds for wound treatment. Dr. Bolton points out that with the introduction of many new silver-containing products for wound care, it is important to develop additional information on their risks and benefits. The article by Lansdown and Williams (How safe is silver in wound care?) summarizes information on the absorption of silver, its fate, and its cutaneous and systemic toxicity. The review also discusses the various forms in which silver has bee

C hronic lower-extremity ulcers are estimated to affect approximately 2.5 million to 4.5 million people in the United States.1 This vast clinical problem is seen mostly in the elderly, the fastest growing segment of the US population. Unhealed ulcers cause substantial disability, morbidity, and long-term care costs. In the US, the estimated annual cost of ulcer treatment may be between $1.9 billion and $2.5 billion. These costs include frequent visits to physicians, care provided by visiting nurses, and often hospital admission for the treatment of accompanying cellulitis.2,3<

Disclosure: This work is supported by Associazione Romana Ricerca Dermatologica (ARRD).

A 50-year-old man presented with bilateral, wide, painless, crural ulcers of 1-year duration on his lower legs. In addition to arterial hypertension, chronic glomerulonephritis, and chronic obstructive bronchopneumopathy (COBP), the patient experienced 3 transient ischemic attacks (TIAs). There was no family history of thromboembolic disease. Cutaneous ulcers were characterized by oval shape, rolled borders, and sticky, suppurative coating with abundant granulation tissue (Figure 1).
Laborator

DFB Acquires EpiSource from IsoTis OrthoBiologics

DFB Pharmaceuticals Inc. (Fort Worth, Tex) announces the acquisition of the wound management activities of EpiSource SA (Upland, Calif) from IsoTis OrthoBiologics (Irvine, Calif).
DFB provides technology-driven products, outsourcing services, and licensing opportunities to the healthcare industry worldwide through its affiliate companies, contract partners, and branded marketing organizations. EpiSource SA, with facilities in Lausanne, Switzerland, focuses on research, development, and manufacturing of cell-based therapies.
In August 2

Case Studies

The authors utilized a solution of 2 liters of normal saline with 500,000 units polymyxin B and 50,000 units of bacitracin in the initial 5 cases detailed below. Programming for all cases included 6 hours of NPWT at 125 mmHg followed by instillation of solution for 90 seconds and a dwell time of 5 minutes. One should note that these agents must be left in the wound for at least 60 seconds before removal to be bactericidal.
Case study 1: diabetic foot ulcer with osteitis of the fifth metatarsal head. A 56-year-old White male with type II diabetes mellitus presented wit