Issue link: https://viewer.e-digitaledition.com/i/441611
HEALTHCARE ADVOCATES, INDUSTRY LEADERS With more than 40 years of experience, our Healthcare Section offers Healthcare Representation & Counseling, Coding Review and Staff Training. We make it possible for you to focus on patient care, while we tackle the legal obstacles you are faced with on an ongoing basis. WE ARE THE HEALTHCARE SECTION OF KRUGLIAK, WILKINS, GRIFFITHS & DOUGHERTY, CO., L.P.A. 4775 Munson Street N.W. | P.O. Box 36963 | Canton, Ohio 44735 | 330-497-0700 | Fax 330-497-4020 John M. Tucker • Randall C. Hunt • Fred J. Haupt Jason F. Haupt • Laura A. Brady Offices in Canton, Akron, Alliance, New Philadelphia & Sugarcreek KWGD.com F OOT WOUND HEALING often equates to limb preser vat ion in t he diabetic patient. In an effort to heal the diabetic foot wound, the surgical podiatrist is often involved in the local ma na gement of in fect ion, including t hat of adjacent bone, a nd the neuropathy- driven repetitive microtrauma to wound tissue. Resultant large post-debridement defects and the profound absence of a protective sensory layer in these patients may indicate incorporating the stability and wound protection that only a circular external fixator can afford. As seen in the case below, the fixator uniquely complements the therapeutic action of advanced wound care and antibiosis. Case Study A 45 year-old male presented with poorly-controlled diabetes, peripheral neuropathy, and an infected left foot ulcer. Initial exam and X-rays revealed severe local infection with soft-tissue gas. The patient underwent two aggressive debridements of his left foot for infection control. To assist the roles of negative-pressure wound therapy and long-term IV antibiosis, this adequately p er f u sed wou nd /fo ot w a s protected with a circular exter- nal fixator (Figure 1a). After three months the fixator was removed and the granulation tissue bed was covered with a split-thickness skin graft (Figure 1b). Dr. Jeffrey Whitaker is Board Certified in Foot and Ankle Surgery and a Fellow of the American College of Foot and Ankle Surgeons. He is Division Head and Associate Professor-Podiatric Surgery at Kent State University College of Podiatric Medicine in Independence, OH. ■ By Jeffrey M. Whitaker, DPM, FACFAS The Role of External Fixation in the Management of Diabetic Foot Wounds Figure 1a Figure 1b 2 0 1 5 JA N UA RY/ F E B R UA RY ■ M D N E W S . CO M ■ MD NEWS Cleveland/Akron/Canton | 1 5