James McGuire

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Journal Club Review

Temple University School of Podiatric Medicine Journal Review Club

Article title: Treatment with LL-37 is safe and effective in enhancing healing of hard-to-heal venous leg ulcers: a randomized placebo controlled clinical trial.
Authors: Alvar Gronberg, DrMedSc; Margit Mahlapuu, PhD; Mona Stahle, MD, PhD; Caroine Whately-Smith, CStat; Ola Rollman, MD, PhD.
Journal name and issue: Wound Repair and Regeneration, September-October 2014 (pages 613-621).
Reviewed by: Lucy Barrow, Temple University School of Podiatric Medicine

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Vashe Wound Solution

by Keval Parikh and James McGuire DPM, PT, CPed, FAPWHc

An important aspect of the field of wound care is the proper preparation of the wound bed. Key points in wound bed preparation include minimizing exudate, assistance in the facilitation of the body’s healing process, and helping to produce a well-vascularized, stable wound that is free of microbes.1

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by Tasneem Masqati and James McGuire DPM, PT, CPed, FAPWHc

The majority of the wounds of the lower extremity are of arterial, venous or neurotrophic (diabetic) origin. Pressure ulcers are less common on the foot and ankle, however when present on the heel they are a particularly difficult wound to treat. Factors such as uncontrolled blood glucose levels, lack of mobility, increased age, impaired sensation, and unrelieved pressure or unlimited trauma all contribute to the development of these wounds.

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by Rizwan Tai and James McGuire DPM, PT, CPed, FAPWHc

According to Centers for Disease Control and Prevention (CDC), the number of adults between the ages of 18-79 with newly diagnosed diabetes has more than tripled in the last 30 years. Foot ulcers are a major complication of uncontrolled diabetes, and 25% of the patients will be affected with foot ulcers in their lifetime, the majority of which lead to lower extremity amputations.

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by Tedman L. Tan and James McGuire DPM, PT, CPed, FAPWHc

The management of diabetic foot ulcers is becoming an increasingly significant concern with the growing population of patients with diabetes in the United States. Most amputations involving the lower extremity in patients with diabetes are preceded by foot ulcers, and in turn, lower extremity amputations are associated with a high 5-year mortality rate at around 45% among individuals with diabetes.1 Therefore, diabetic foot ulcers require special attention due to the possible life-threatening complications associated with such wounds.

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gauze

by Keval Parikh and James McGuire DPM, PT, CPed, FAPWHc

There are many different kinds of wound dressings available. Choosing one to use depends on the unique characteristics of the wound. According to Watson and Hodgkin, the ideal wound dressing should exhibit a number of characteristics by providing the following: moisture and exudate management, prevention of saturation and strikethrough, diffusion of wound gases, microorganism protection, mechanical protection; localized temperature and pH control; removal/change comfort; wound odor management; cosmetic acceptability; non-allergenic composition; non-contamination of the wound bed; and cost-effectiveness.1

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marathon liquid skin protectant

by Peter Smith and James McGuire DPM, PT, CPed, FAPWHc

Marathon® Liquid Skin Protectant by Medline Industries, Inc. is a versatile non-stinging barrier film that provides protection for at-risk skin or damaged skin. Marathon® comes in single use applicator tubes that have a built-in sponge tip. Each tube contains enough liquid skin protectant to cover an area of 10cm2. The barrier film created is breathable, flexible and durable relative to other liquid skin products.

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By Bradley W. Lind and James McGuire DPM, PT, CPed, FAPWHc

Venous leg ulcers are a type of lower extremity wound complicated by excess fluid production, periwound edema, and high bioload produced by venous insufficiency often leading to secondary lymphedema. The Coban™ 2 Layer Compression Therapy System, created by 3M Health Care, was designed to achieve sustained therapeutic compression, while improving the ease of application, and reducing slippage of the dressing during wear. The reduction in layers of the dressing also allows the patient to wear their own footwear and avoid the purchase of a surgical shoe.

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by Elliot Fialkoff and James McGuire DPM, PT, CPed, FAPWHc

There are numerous causes for ulcerations including pressure, venous insufficiency, arterial insufficiency, and neuropathic wounds. All have very different characteristics and require very different interventions. One thing that all chronic wounds have in common is the accumulation of necrotic material, biofilm or non-viable materials secondary to a prolonged inflammatory stimulus to the wound. In order for an ulcer to heal properly this "slough" must be regularly removed from the wound base so that healthy granular tissue can develop.

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by Sejal Bhojani and James McGuire DPM, PT, CPed, FAPWHc

RTD® (Retro-Tech Dressing) is a foam wound dressing that has been designed to promote healing in chronic wounds by utilizing silver ion (Ag+), gentian violet (GV), and methylene blue (MB). Ag+ ions kill bacteria in the wound fluid absorbed by the dressing. GV works as an antifungal, antimicrobial, and mild analgesic, and MB, which is strongly bound to the foam matrix, has an affinity for negatively charged proteins found in the components of exudate.

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