Volume 15 - Issue 7 - July 2002
There is a tendency for people to fear the unknown. Unfortunately, stereotypes abound about the incapability of the podiatric profession. It is up to everyone involved in the field directly or indirectly not to perpetuate this way of thinking.
Bias towards podiatry is a double-edged sword. On one side, the laypeople are constantly questioning the profession.
Chronic wounds such as diabetic foot ulcers, venous stasis ulcers and decubitis ulcers are leading causes of morbidity and mortality in elderly patients and significantly contribute to health care costs.1-4 Wounds of these types often lead to complications such as infection and amputation.5-7 The ADA currently reports diabetes is prevalent in at least 17 million Americans, many of whom do not know they have the disease. Of these, approximately 15 percent will experience a foot ulcer or other complication requiring hospitalization during the course of the disease.8, 9
Similarly, venous wounds
Editor's Perspective »
New figures from the Centers For Disease Control (CDC) continue to cast a sobering view on treating diabetes in the years to come. Now there are 17 million Americans who have the disease and nearly six million of them are unaware they have the condition, according to CDC estimates. The prevalence of the disease, the sixth-leading cause of death in the United States, has increased 33 percent in the last decade. Even more troubling is the fact that the demographics of the diabetes population are growing wider.
The CDC notes that over a million new cases will be diagnosed each year among patien
Wound Care Q&A »
Many leading researchers and wound care practitioners have shown that one of the most important elements in treating wounds is performing regular debridement of tissue (such as eschar) which interferes with wound healing. Timothy Shea, DPM, says the standard approach is to initially debride eschar (and other non-viable tissue) until you get down to good viable tissue and do subsequent debridement every seven to 10 days until you see good granulation tissue.
But what about the presence of black eschar? According to Alexander Reyzelman, DPM, there is a bit of controversy over whether you should
Surgical Pearls »
Metatarsalgia may develop from osseous, neurological, vascular or dermal etiologies. The causes are numerous and commonly involve a cavus foot structure, a long second metatarsal, short first metatarsal, hypermobile first ray, iatrogenic pain from forefoot surgery or manifest from a rheumatology-induced systemic disease. When symptoms persist, you may see callus lesions develop under the affected metatarsal. Keep in mind that these lesions can lead to stress fractures and compensation-induced pains in the lower extremity and back.
About four of 1,000 people will develop a leg ulcer during their lives, but the prevalence of leg ulcers rises dramatically with age, increasing to about 1 percent in people over the age of 60 and 2 percent in people over the age of 80. In the U.S., about 3 million people suffer from leg ulceration, costing an annual $4 billion in treatment costs and losses of over 2 million days from work.
In general, diagnosing the cause of leg and foot wounds requires examining the wound, the extremity and the patient. Let’s start by taking a look at venous problems.
Any disease state that leads to ven
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