On diabetic foot, wound healing, amputation prevention, and the merger of consumer tech with medical devices
Does the skin heat up before it breaks down in diabetic foot ulceration? Compelling and provocative work from our Dutch colleagues. They've published more on this important subject in the past few years than anyone and what we may be seeing is that, for some patients, thermometry may not be as accurate. While this idea... Continue Reading →
Accuracy of the pedal acceleration time to diagnose limb ischemia in patients with and without diabetes using the WIfI classification Excellent work from Castro-Santos and coworkers. Accuracy of the pedal acceleration time to diagnose limb ischemia in patients with and without diabetes using the WIfI classification Introduction: Evaluation of limb hemodynamics using the ankle–brachial index... Continue Reading →
From our team led by super student Mark Swerdlow! Mark Swerdlow 1, Jessica Lo 2, David G Armstrong 3 Objective: Evaluate the inter- and intra-rater reliability of a wound assessment tool in iPhone 12 and 13 mini modalities against a validated iPad mini/Structure Sensor configuration. Approach: We assessed a wound measurement application (eKare inSight) for result consistency in patients presenting with wounds.... Continue Reading →
This work by our colleagues from the Deaconess and Joslin constitutes another advance in the slow, steady march toward deriving an actionable value from hyperspectral imaging. Bottom line: Using oxyHb 50 as the cutof point to predict DFU complete healing, Visit 1 oxyHb measurement provided 85% sensitivity, 70% specificity, 50% positive predictive value and 93%... Continue Reading →
The Value of Infrared Thermography to Assess Foot and Limb Perfusion in Relation to Medical, Surgical, Exercise or Pharmacological Interventions in Peripheral Artery Disease Here is work from our Italian colleagues Piva and coworkers. Infrared thermography (IRT) is a promising imaging method in patients with peripheral artery disease (PAD). This systematic review aims to provide... Continue Reading →
From our colleagues in Chennai. Abstract Diabetic Foot Syndrome (DFS) is the prime impetus for most of the lower extremity complications among the diabetic subjects. DFS is characterized by aberrant variations in plantar foot temperature distribution while healthy subjects exhibit a symmetric thermal pattern between the contralateral and ipsilateral plantar feet. Thus, "asymmetry analysis" of... Continue Reading →
This from our colleagues in Carlisle, UK. We see more chairside/bedside diagnostics and theragnostics to help measure what we manage. Background: Point-of-care testing for infection might help podiatric physicians optimize management of diabetic foot ulcers (DFUs). Glycologic's proprietary GLYWD product has been developed to detect changes in a patient's immunologic/inflammatory response related to wound infection. We... Continue Reading →
Bone cultures? Clean margins for pathology? Both? These data from Voon and colleagues add more fuel to the discussionBackground: Trans-phalangeal and trans-metatarsal amputation, collectively termed 'minor amputations' are important procedures for managing infections of diabetes-related foot ulcers (DFU). Following minor amputation, international guidelines recommend a prolonged course of antibiotics if residual infected bone on intra-operative... Continue Reading →
Strong work from our Staffordshire colleagues Chatzistergos and Chockalingam who continue to help push the envelope in helping us collectively measure what we manage. An in vivo model for overloading-induced soft tissue injury This proof of concept study demonstrates that repetitive loading to the pain threshold can safely recreate overloading induced soft tissue damage and... Continue Reading →
Site-Specific, Critical Threshold Barefoot Peak Plantar Pressure Associated with Diabetic Foot Ulcer History: A Novel Approach to Determine DFU Risk in the Clinical Setting Excellent, pragmatic work from our Mancunian colleagues, Caroline Abbott and coworkers. Background and Objectives: Barefoot peak plantar pressures (PPPs) are elevated in diabetes patients with neuropathic foot ulcer (DFU) history; however, there... Continue Reading →
