Clinics in Podiatric Medicine and Surgery RSS feed: Current Issue. Each issue of Clinics in Podiatric Medicine and Surgery updates you on the latest trends in patient management; keeps you up to date on the newest advances; and provides a sound basis for choosing treatment options. Each issue focuses on a single topic in podiatry and is presented under the direction of an experienced guest editor.http://www.podiatric.theclinics.com/?rss=yesElsevier Inc.en © 2009 Published by Elsevier Inc. All rights reserved. Clinics in Podiatric Medicine and Surgery0891-8422264October 2009 © 2009 Published by Elsevier Inc. All rights reserved. healthpermissions@elsevier.comhttp://www.podiatric.theclinics.com/article/PIIS0891842209000883/abstract?rss=yesContents10.1016/S0891-8422(09)00088-3Clinics in Podiatric Medicine and Surgery 26, 4 (2009)2009-10-01Clinics in Podiatric Medicine and Surgery2009-10-01264S0891-8422(09)X0004-2viiixhttp://www.podiatric.theclinics.com/article/PIIS0891842209000895/abstract?rss=yesForthcoming Issues10.1016/S0891-8422(09)00089-5Clinics in Podiatric Medicine and Surgery 26, 4 (2009)2009-10-01Clinics in Podiatric Medicine and Surgery2009-10-01264S0891-8422(09)X0004-2xxhttp://www.podiatric.theclinics.com/article/PIIS0891842209000767/abstract?rss=yes This issue focuses on the latest advancements, techniques, and innovations in wound and bone healing. A variety of topics covering the management of acute and chronic wounds and also bone fracture repair are described in detail. Recent advances in biotechnology and research in bioscaffolds, dermal replacements, orthobiologics, and bone stimulation have added a multitude of options to the surgeon's armamentarium. Dr. Landsman and his colleagues have done an extraordinary job of addressing the most beneficial changes in clinical management of recalcitrant wounds and bone healing. Particular emphasis is given to the soft tissue reconstruction of diabetic foot wounds and to the treatment of diabetic nonunions.ForewordThomas Zgonis10.1016/j.cpm.2009.08.010Clinics in Podiatric Medicine and Surgery 26, 4 (2009)2009-10-01Clinics in Podiatric Medicine and Surgery2009-10-01264S0891-8422(09)X0004-2xixihttp://www.podiatric.theclinics.com/article/PIIS0891842209000780/abstract?rss=yesSince the late 1700s, when John Hunter, MD, began his scientific assessment of human anatomy, and applied these principles to understanding human development and function, physicians have looked for better ways to make wounds heal and stimulate the growth of bone. The science of getting bones to heal is still in its early stages, although the last 2 decades have shown us that the process is not only an active one, but potentially, one that can be controlled. The discovery of the piezoelectric effect and the generation of charges in bone placed under mechanical loads was a major breakthrough in its day. Subsequently, this led to the pioneering work of Bassett and colleagues. Who discovered that electrical fields can actually be created and used to trigger an ionic response in bone to stimulate proliferation. From there, refinement of stimulation protocols and improved understanding of how bones respond to charged stimulation led to the use of magnetic fields to trigger bone growth.PrefaceAdam Landsman10.1016/j.cpm.2009.08.013Clinics in Podiatric Medicine and Surgery 26, 4 (2009)2009-10-01Clinics in Podiatric Medicine and Surgery2009-10-01264S0891-8422(09)X0004-2xiiixvhttp://www.podiatric.theclinics.com/article/PIIS0891842209000688/abstract?rss=yesThe biological and physical augmentation provided by extracellular matrix (ECM) derived implants continues to challenge and refine the conventional wisdom of biomaterials. It is now appreciated that different tissue-processing methodologies can produce ECM devices with characteristic post-implantation responses ranging from the classic foreign body encapsulation of a permanent implant, to one where the implant is degraded and resorbed, to one where the processed ECM implant is populated by local fibroblasts and supporting vasculature to generate a new, metabolically active tissue (gTissue). This article reviews the multiple ECM devices available clinically and highlights the impact of tissue source and processing on physicomechanical properties and host-implant interactions, with regard to surgical applications and clinical considerations.Extracellular Matrix Biomaterials for Soft Tissue RepairKevin G. Cornwell, Adam Landsman, Kenneth S. James10.1016/j.cpm.2009.08.001Clinics in Podiatric Medicine and Surgery 26, 4 (2009)2009-10-01Clinics in Podiatric Medicine and Surgery2009-10-01264S0891-8422(09)X0004-2507523http://www.podiatric.theclinics.com/article/PIIS0891842209000779/abstract?rss=yesCollagen is one of the fundamental building blocks of skin and plays a critical role in wound healing. This article looks at the wide array of collagen and living skin equivalent products containing collagen and living cells, and at how these may be used in the treatment of diabetic foot ulcers. Solid collagen, foamed collagen, living skin equivalents, and living cadaveric skin are considered. Clinical examples are included, along with a brief discussion of wound dressings that may help to enhance the incorporation of these materials.The Role of Collagen Bioscaffolds, Foamed Collagen, and Living Skin Equivalents in Wound HealingAdam Landsman, Drew Taft, Kevin Riemer10.1016/j.cpm.2009.08.012Clinics in Podiatric Medicine and Surgery 26, 4 (2009)2009-10-01Clinics in Podiatric Medicine and Surgery2009-10-01264S0891-8422(09)X0004-2525533http://www.podiatric.theclinics.com/article/PIIS0891842209000640/abstract?rss=yesBiologic scaffolds have become an integral part of surgical soft tissue reconstruction in recent years. The increased use of these materials can be partially attributed to poor long-term outcomes with synthetic products as well as the cost and morbidity associated with allografts and autografts. Bioscaffolds can augment natural healing processes of tendons and ligaments while providing additional structural support. Although these implants lack the mechanical strength of synthetics and other transplants, proper preparation can optimize their load-sharing capacity. This article presents methods that can improve these characteristics of bioscaffolds. Available studies in foot and ankle applications have shown minimal complications in a variety of techniques.Bioscaffolds and the Reconstruction of Ligaments and Tendons in the Foot and AnkleJeremy J. Cook, Emily A. Cook10.1016/j.cpm.2009.07.004Clinics in Podiatric Medicine and Surgery 26, 4 (2009)2009-10-01Clinics in Podiatric Medicine and Surgery2009-10-01264S0891-8422(09)X0004-2535543http://www.podiatric.theclinics.com/article/PIIS0891842209000615/abstract?rss=yesTreatment of plantar fat pad migration and atrophy has caused concern for decades. Patients can present with pain, callus formation, or ulceration. The purpose of this article is to review the results of a consecutive series of patients treated for fat pad atrophy of the plantar foot, using a minimally invasive implantation of an acellular human dermal allograft as a tissue augmentation. This material was chosen for the fat pad supplementation because of previous reports of success in tendon and ligament augmentation, wound healing, and interpositional arthroplasty.Augmentation of Atrophic Plantar Soft Tissue with an Acellular Dermal Allograft: A Series ReviewThomas M. Rocchio10.1016/j.cpm.2009.07.001Clinics in Podiatric Medicine and Surgery 26, 4 (2009)2009-10-01Clinics in Podiatric Medicine and Surgery2009-10-01264S0891-8422(09)X0004-2545557http://www.podiatric.theclinics.com/article/PIIS0891842209000627/abstract?rss=yesOver the past two decades, autologous platelets that have been sequestered, concentrated, and mixed with thrombin to generate growth factor–concentrated platelet-rich plasma for application to bone and wounds to aide healing have been a subject of great interest. This article reviews the literature related to the use of autologous platelet-rich plasma in bone and wound healing, and reviews the processes necessary to secure a high concentration of viable platelets. Although not yet definitive, autologous platelet-rich plasma has been shown to be safe, reproducible, and effective in mimicking the natural process of bone and wound healing.Bone and Wound Healing Augmentation with Platelet-Rich PlasmaSimon E. Smith, Thomas S. Roukis10.1016/j.cpm.2009.07.002Clinics in Podiatric Medicine and Surgery 26, 4 (2009)2009-10-01Clinics in Podiatric Medicine and Surgery2009-10-01264S0891-8422(09)X0004-2559588http://www.podiatric.theclinics.com/article/PIIS0891842209000639/abstract?rss=yesIn reconstructive foot and ankle surgery, the use of bone graft is common. Whether for trauma, acquired or congenital deformities, arthrodeses, joint replacement, bone loss from infection, or bone tumor resection, the foot and ankle surgeon must be knowledgeable about current bone grafting options to make informed decisions. Innovation and technologic advances have produced an impressive and exciting array of options, advancing us closer to mimicking the gold standard: autograft. However, the sheer volume of available products makes it challenging for the foot and ankle surgeon to stay abreast of current bone graft technology. The purpose of this article is to simplify and classify current bone grafting options, discuss advantages and disadvantages, and provide relevant clinical examples.Bone Graft Substitutes and Allografts for Reconstruction of the Foot and AnkleEmily A. Cook, Jeremy J. Cook10.1016/j.cpm.2009.07.003Clinics in Podiatric Medicine and Surgery 26, 4 (2009)2009-10-01Clinics in Podiatric Medicine and Surgery2009-10-01264S0891-8422(09)X0004-2589605http://www.podiatric.theclinics.com/article/PIIS0891842209000664/abstract?rss=yesDuring the last few decades, electrical current stimulation has gone from an investigational modality to an accepted method of treatment to assist with bone healing. This article provides an overview of electrical bone stimulation for nonunions in the foot and ankle.Bone Growth Stimulation for Foot and Ankle NonunionsCrystal L. Ramanujam, Ronald Belczyk, Thomas Zgonis10.1016/j.cpm.2009.08.003Clinics in Podiatric Medicine and Surgery 26, 4 (2009)2009-10-01Clinics in Podiatric Medicine and Surgery2009-10-01264S0891-8422(09)X0004-2607618http://www.podiatric.theclinics.com/article/PIIS0891842209000676/abstract?rss=yesSince its introduction into the market, negative pressure wound therapy (NPWT), also known as topical negative pressure, has become an important adjuvant therapy for the treatment of many types of wounds. Surgeons and physicians of all subspecialties have adopted NPWT into their practices. NPWT has become a mainstay in the management of lower extremity soft tissue pathology, especially in patients with traumatic, diabetic, postsurgical, and peripheral vascular disease-associated wounds. This article reviews the background, currently understood mechanisms of action, applications, contraindications, reported complications, advantages, criticisms, and techniques in the lower extremity.An Overview of Negative Pressure Wound Therapy for the Lower ExtremityClaire M. Capobianco, Thomas Zgonis10.1016/j.cpm.2009.08.002Clinics in Podiatric Medicine and Surgery 26, 4 (2009)2009-10-01Clinics in Podiatric Medicine and Surgery2009-10-01264S0891-8422(09)X0004-2619631http://www.podiatric.theclinics.com/article/PIIS0891842209000652/abstract?rss=yesThe goal of biologic resurfacing is to provide a smooth joint surface with a low coefficient of friction, which allows the joint to function with near normal biomechanics, as well as provide intermittent pressure, to the subchondral and cancellous bone. This unique combination often results in the formation of a “neocartilage-like” structure that can reduce pain and restore biomechanics. As well as giving a brief history of cutis arthroplasty, this article describes cases in which the ankle and first metatarsophalangeal joint underwent biologic resurfacing, with a 2-year postoperative follow up.Biologic Resurfacing of the Ankle and First Metatarsophalangeal Joint: Case Studies with a 2-Year Follow-UpStephen A. Brigido, Michael Troiano, Harold Schoenhaus10.1016/j.cpm.2009.07.005Clinics in Podiatric Medicine and Surgery 26, 4 (2009)2009-10-01Clinics in Podiatric Medicine and Surgery2009-10-01264S0891-8422(09)X0004-2Current Concepts & Techniques in Foot & Ankle Surgery633645http://www.podiatric.theclinics.com/article/PIIS0891842209000755/abstract?rss=yesThe Achilles tendon is the thickest and strongest tendon in the human body. In spite of this, it is also one of the most frequently ruptured tendons. This article reviews the history of and debate about the appropriate course of treatment. A case study of an Achilles repair illustrates that the use soft tissue matrices is a successful adjunct to both the primary repair and gastrocnemius recession, with full return to activity and no inflammatory response at long-term follow up. The authors anticipate that the use of soft tissue matrices for the repair of tendon and soft tissue defects will expand over time as this material has distinct advantages over synthetics and highly crosslinked biologic materials.Use of Soft Tissue Matrices as an Adjunct to Achilles Repair and ReconstructionBrian S. Stover, Charles M. Zelen, David L. Nielson10.1016/j.cpm.2009.08.011Clinics in Podiatric Medicine and Surgery 26, 4 (2009)2009-10-01Clinics in Podiatric Medicine and Surgery2009-10-01264S0891-8422(09)X0004-2Current Concepts & Techniques in Foot & Ankle Surgery647658http://www.podiatric.theclinics.com/article/PIIS0891842209000949/abstract?rss=yesIndex10.1016/S0891-8422(09)00094-9Clinics in Podiatric Medicine and Surgery 26, 4 (2009)2009-10-01Clinics in Podiatric Medicine and Surgery2009-10-01264S0891-8422(09)X0004-2659665