Use of hyperspectral imaging to predict healing of diabetic foot ulceration.

Our main objective was to validate that hyperspectral imaging via a new portable camera carries the potential to provide a reliable clinical biomarker that can predict DFU healing. We recruited patients with diabetic foot ulceration (DFU) without peripheral arterial disease, infection or other serious illness. Using an hyperspectral imaging (HSI) apparatus, post-debridement hyperspectral images were taken evaluating the ulcer size, periwound oxyhemoglobin (OxyHb), deoxyhemoglobin level (DeoxyHb) and oxygen saturation (O Sat) for four consecutive visits.

Subtalar Arthroereisis Implantation in Acquired Neuropathic Pes Planus: A Preliminary Report Detailing a Minimally Invasive Approach to Healing Medial Column Ulcerations.

Ulcerations under the medial column in patients with acquired neuropathic pes planus may be intractable to conservative techniques such as regular debridement, offloading, bracing, and accommodative shoes. When surgery becomes necessary for these patients, the foot and ankle surgeon has the option of exostectomy, medial column beaming, medial column fusion, and external fixation, among others. In the case of a flexible midfoot collapse, the option of arthroereisis for indirect medial column support may be warranted.

A Retrospective Case Series of a Dehydrated Amniotic Membrane Allograft for Treatment of Unresolved Diabetic Foot Ulcers.

Background: Foot ulcers are among the most serious complications of diabetes and can lead to amputation. Diabetic foot ulcers (DFUs) often fail to heal with standard wound care, thereby making new treatments necessary. This case series describes the addition of a dehydrated amniotic membrane allograft (DAMA) to standard care in unresolved DFUs.

Growth factors in wound healing: the present and the future?

Numerous clinical studies have confirmed the pivotal role growth factors play in wound healing and their diminished levels in the chronic wound. Despite promising early studies treating chronic wounds with growth factors, results with traditional bolus dosing of a single growth factor have yielded insignificant results. Disappointing results have been theorized to be the result of growth factors inherent short half-life, a hostile microenvironment rich in protease activity, and poor delivery mechanisms failing to deliver effective dosages in an appropriate temporal manner.

Offloading of the diabetic foot: orthotic and pedorthic strategies.

The diabetic foot is more susceptible than the non-diabetic foot to collapse. This frequently leads to bony prominences followed by ulceration. Offloading of areas of increased pressure is paramount to ulcer prevention and healing.

Validation of the American College of Foot and Ankle Surgeons Scoring Scales.

The American College of Foot and Ankle Surgeons (ACFAS) assembled a task force to develop a scoring scale that could be used by the membership and practitioners-at-large. The original publication that introduced the scale focused primarily on use of the scale and provided only brief background on the development of the health measurement instrument. Concerns regarding the validity and reliability of the scale were raised within the professional community, and ACFAS assembled a task force to address these concerns.

Foot muscle energy reserves in diabetic patients without and with clinical peripheral neuropathy.

OBJECTIVE To investigate changes in the foot muscle energy reserves in diabetic non-neuropathic and neuropathic patients. RESEARCH DESIGN AND METHODS We measured the phosphocreatinine (PCr)/inorganic phosphate (Pi) ratio, total (31)P concentration, and the lipid/water ratio in the muscles in the metatarsal head region using MRI spectroscopy in healthy control subjects and non-neuropathic and neuropathic diabetic patients. RESULTS The PCr/Pi ratio was higher in the control subjects (3.

The Charcot foot: a clinical challenge.

The Charcot foot (CF) is a clinical challenge. The CF occurs in the presence of sensory neuropathy; its etiology and pathogenesis are constantly debated. The aim of this short article is to examine therapeutic options from the perspective of experienced podiatrists.

Elective surgery of the diabetic foot.

It has been clearly demonstrated that elective surgery can be performed in the neuropathic foot. If infection is controlled and arterial supply is adequate, limb salvage can be greatly enhanced with an aggressive approach to elective procedures in the patient who has diabetes.