Equine pericardium collagen wound dressing in the treatment of the neuropathic diabetic foot wound: a pilot study.

BACKGROUND: Treatment of diabetic foot wounds remains a major health-care issue, with diabetic foot ulcers representing the most common causal pathway to lower-extremity amputation. Although several investigations have examined topical collagen-based dressings, none have specifically looked at equine pericardium. We, therefore, evaluated the effect of the equine pericardium dressing on neuropathic foot wounds. METHODS: Twenty-three consecutive patients with 34 neuropathic foot wounds were evaluated as part of a pilot study. An equine pericardium dressing was applied in a standard manner, and the patients followed a standard postapplication treatment protocol. Changes in wound size were recorded when the equine dressing was removed and 4 and 12 weeks after application. Patients underwent dressing changes every 3 to 4 days until healed or for 12 weeks. RESULTS: Thirty-two wounds in 22 patients were prospectively available for evaluation. On enrollment, the median wound size was 299 mm2. When the equine material was removed (mean, 2.9 weeks), 30 of the wounds (94%) had improved, with a median size of 115 mm2 and an average reduction in size of 44.3% (P<.0001). At 4 weeks, the average decrease in wound size was 52.3% (P<.0001). At 12 weeks, 15 wounds (47%) had healed. CONCLUSIONS: This first report of equine pericardium used to treat neuropathic foot ulcerations demonstrates that the equine pericardium dressing is a safe and beneficial treatment for neuropathic wounds.

Effect of diabetes mellitus on the material properties of the distal tibia.

This investigation evaluates the effects of diabetes on the mechanical properties of human bone, specifically, the tibia. Seven diabetic and seven nondiabetic human (male) cadaveric distal tibiae were used in this study. The average age of the diabetic cadaveric samples was 51 years (range, 46-61 years), and the average age of the nondiabetic cadaveric samples was 75 years (range, 67-85 years). Three-point bending tests for strength and stiffness were performed on a small sample of each distal tibia. Each specimen was loaded at a constant rate until failure. From the recorded curve of load versus displacement, the ultimate and yield strength of bone and the bending modulus of bone were calculated. The diabetic samples were generally weaker than the older, nondiabetic samples, but no statistically significant differences were found in the elastic modulus (P = .29), yield strength (P = .90), ultimate strength (P = .46), and fracture toughness (P = .78), leading to speculation that diabetes has an effect similar to that of aging on the musculoskeletal system.

Reproducibility of gait analysis variables: one-step versus three-step method of data acquisition.

The purpose of the study was to evaluate the preciseness and repeatability of EMED-SF platform data collection using two different protocols. Gait variables of five healthy women and five men, with an average age of 27.3 +/- 3.2 years, weighing 67.5 +/- 13.3 kg, were evaluated. With a one-step and a three-step approach of data collection, peak pressure, pressure-time integral, and contact time were measured. Peak pressures were not significantly different between both methods. Significant differences were found between both methods in total contact time and pressure-time integral. Both methods were comparable in peak pressures (error between methods = 7.0), while the one-step protocol was more repeatable (intraclass correlation coefficient = 0.59) than the three-step protocol (intraclass correlation coefficient = 0.36). The error between methods for total contact time and pressure-time integral were 143.3 and 50.1, respectively, suggesting that the two protocols lead to different results. The one-step protocol (intraclass correlation coefficient = 0.40) had a higher repeatability than the three-step protocol (intraclass correlation coefficient = 0.31). The one-step protocol has some advantages over the three-step protocol as far as repeatability, simplicity, convenience, and time conservation are concerned. For measuring total contact time and pressure-time integrals, both methods have comparable repeatability, although the protocols lead to different outcomes.