Clinics in podiatric medicine and surgery
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Clin Podiatr Med Surg · Oct 1991
ReviewWound dressings of the nineties: indications and contraindications.
A revolution in wound management has occurred over the past 3 decades. A plethora of wound care dressings appear to enhance the wound repair process in acute and chronic wounds. However, extensive research is needed to discriminate between the beneficial effects of increased attention to all aspects of patient care, including wound management, and the salutary effects of dressing materials.
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Pseudomonal infections of the skin, soft tissue, bone, and toe web may often be very difficult to treat. This article reviews the microbiology, pathogenesis, and treatment of pseudomonal infections that are related to podiatric medicine and surgery.
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Animal bite wounds of the lower extremity are considered high-risk wounds for infection, especially in the medically compromised individual. Management should be aggressive. ⋯ Empiric use of an agent containing clavulanic acid or sulbactam is suggested until results are obtained from the bacterial culture and sensitivity. Tetanus prophylaxis should be considered for every bite wound, whereas rabies prophylaxis is warranted in selected cases.
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Often overlooked in the differential diagnosis of heel pain is neuroma of the medial calcaneal branch of the posterior tibial nerve. Heel neuroma is an important disorder of the foot that has been misdiagnosed by physicians since the early 1900s as heel spur syndrome. The authors show how heel pain rarely has anything to do with calcaneal exostosis, but instead could be related to heel neuroma.
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Clin Podiatr Med Surg · Apr 1989
Case ReportsNail changes associated with scleroderma: a case report.
A case report and literature review on the association of nail changes and scleroderma was presented. The exact etiology of these nail changes seen in scleroderma and of the disease entity itself, has not yet been determined. The current treatment regimen, which is at best supportive, was discussed. ⋯ Nonetheless, there are still questions that remain to be answered regarding the nail changes associated with scleroderma. For example, are these nail changes the result of Raynaud's phenomenon and its associated arterial insufficiency, or are they a normal sequelae of the integumentary degeneration so characteristic of scleroderma? Whatever the answer may be, it should be recognized that these changes are a source of clinical concern. Practitioners should take note of this clinical entity and record their findings so that these perplexing questions, as well as many others, may be discussed in the future.