The Background   Since the 1980s, honey has become more widely used in wound care. The antibacterial property of honey was first reported in 1882.  Initially honey was thought to be effective through an osmotic process.  In 1991, researchers compared the potency of 345 samples of honey at different dilutions and identified two specific honeys […]

The Background   Wound healing consists of four overlapping phases:  hemostasis, inflammation, proliferation, and tissue remodeling.  These phases must occur in a specific sequence at a specific time and intensity to result in a healed wound.  Wounds that have impaired healing, including delayed healing, generally have not progressed through the normal stages of healing.  These […]

The Background   Leprosy and diabetes are obviously different disease processes.  However, both diseases may result in diminished sensation in the feet.  The diminished sensation increases the risk for both painless injury and potential ulceration or wounds.  Some of the research in leprosy has direct application in the management of diabetic feet.  Specifically the research […]

Calciphylaxis is term applied to a syndrome that exhibits rapid subcutaneous tissue calcification.  A more descriptive term, calcific uremic arteriolopathy (CUA), may be more appropriate given the theorized pathophysiology.  Traditionally, the hypothesis has been that there is an underlying problem with calcium homeostasis, which results in the calcification of small vessels.  Associated with the calcification […]

The Background   Negative Pressure Wound Therapy (NPWT) has become widely accepted as a treatment modality for a broad range of wound indications.  There have been well over 1000 peer-reviewed publications describing the efficacy and safety of NPWT.  The challenge and opportunity is to condense the information into evidence-based recommendations.   The Study   The […]

The Background   Chronic leg ulcers represent an increasing disease burden.  Venous insufficiency is the predominant causative factor in up to 50% of patients with chronic leg ulcers.  In about 15% of these patients, the ulcers develop as a result of arterial insufficiency or a combination of venous and arterial insufficiency.    These ulcers have […]

The Background   Diabetic foot ulcers are a common complication of diabetes.  The morbidity associated with diabetic foot ulcers is high.  Further, greater than 85% of lower extremity amputations occur as a result of these ulcers.  Certainly, delayed healing of ulcers have an impact on an individual’s mobility, quality of life, and potential for further […]

The Background:   Foot ulcers are a common complication of Diabetes.  The lifetime risk of developing a foot ulcer may be as high as 15%.  The important factor is that patients with foot ulceration run the risk of major amputation.  The problem is that diabetic foot ulcers are a heterogeneous pathological entity caused by many […]

  The Background:   Since the mid 1960s, the prevailing thought has been that wound healing is optimal when there is a moist environment versus a dry environment.  Occlusive or semi-occlusive dressings were developed to promote both an optimum wound environment including re-epithelialization, wound closure, absorption of fluids, and painless application and removal.  These dressings […]

The Background:   The concept of biofilms is only beginning to be understood in wound care.  Biofilm is created when a single cell bacterium attaches on the wound surface to the extracellular matrix protein.  The bacterium begins to rapidly produce extracellular polymetric substance (EPS) and within hours can create a microcolony.  As time progresses, the […]