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Special Features


From the American Podiatric Medical Association 2018 Annual Meeting

2018 Washington, DC – By Nicole Wetsman

Low Cost Insulin Spray Improves Healing of Diabetic Foot Ulcers

Spraying insulin into an open wound improves the healing of diabetic foot ulcers in diabetic patients—both type 1 and type 2, reported a poster entitled, The Outcomes of Local Flushing of Insulin on Wound Healing in Patients with Diabetic Foot Ulcers.

Foot Type Determines Effect of Orthotics on Muscle Activity

Adding a lateral bar beneath foot orthoses does not significantly alter activity in the pronator muscles in people with high-arched feet, according to preliminary data from a poster entitled, Effects of Two Types of Foot Orthoses on the Biomechanics of Participants with Cavus Feet During Walking.

Treating Vascular Malformations Without Surgery

Arteriovenous malformation can be managed non-surgically according to a poster presented by Rothman Institute podiatrists Faith Schick, PDM, and Nicholas Taweel, DPM. DPT. Their case report detailed how they resolved the patient’s symptoms and the case, highlighting the opportunities for non-operative treatment in this condition.

Office-based Toe Amputations Are Safe and Efficient

As patients seek more affordable care options, moving surgical procedures from the hospital-based operating room to less expensive, more convenient locations is one tactic being explored. But can such procedures be done safely in these outpatient settings? New research from Podiatrists in the Department of Surgery at the Southern Arizona Veteran Affairs Health Care System provides evidence that they can…and that patients like the convenience.

Negative Pressure Wound Therapy Creates Positive Clinical Outcomes in an Outpatient Setting

A new, disposable negative pressure wound therapy (NPWT) system effectively reduced the volume of varied wound types on four patients in an outpatient setting, reported Windy Cole, podiatrist at University Hospitals Ahuja Medical center, in a poster entitled, Management of Small, Lower Extremity Wounds in the Ambulatory Setting Using a Disposable, Mechanically Powered Negative Pressure Wound Therapy System.

The DFU Dilemma: Is the Total Contact Cast a True “Gold Standard”?


In March 2017, McGuire and Sebag wrote: “Early diagnosis and intervention for diabetic foot wounds is essential for the prevention of complications associated with these ulcers. We are all familiar with the term ‘the golden hour’ with respect to the first 60 minutes after the onset of a stroke or cardiac arrest. The rapid initiation of aggressive care is the key to positive outcomes for the patient. In this way, the diabetic foot ulcer (DFU) also has a golden hour. The 4-week period following the onset of a diabetic ulcer is a critical time for treatments aimed at preventing the development of a chronic wound, staving off infection, and allowing for early closure of the skin. Wounds that have not achieved 50% closure within the first 4 weeks are destined to become difficult-to-heal chronic wounds. A fundamental component of early intervention and resolution of diabetic foot ulcers is the use of an array of offloading devices that includes everything from total contact casting to depth shoes with molded inserts.”1 However, as they go on to document, there is no consensus among practitioners.

By Harry L. Penny, DPM, DABPM, FAPWHc


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