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1.  Novel Use of Insulin in Continuous-Instillation Negative Pressure Wound Therapy as “Wound Chemotherapy” 
Negative pressure wound therapy (NPWT) is frequently employed in the treatment of complex wounds. A variety of wound chemotherapeutic agents such as insulin, which acts as a growth factor, may prove helpful in treatment as well. We present a case report in which insulin was used as a chemotherapeutic agent in continuous-instillation NPWT. To our knowledge, this is the first report in the literature describing this method of delivery.
PMCID: PMC2909511  PMID: 20663443
diabetic foot ulcers; insulin; negative pressure wound therapy; wound chemotherapy
2.  Partial Calcanectomy in High-Risk Patients With Diabetes: Use and Utility of a “Hurricane” Incisional Approach 
Eplasty  2010;10:e17.
Introduction: Plantar heel ulcers in people with diabetes represent a difficult challenge to the treating physician. They become even more difficult with underlying osteomyelitis. When this infection is in the calcaneus it typically results in a partial or total calcanectomy or even more frequently, high-level amputation. Methods: In this article, we describe a novel serpentine incisional approach to the plantar and (if necessary) posterior heel allowing for ample exposure and facilitating closure predominantly along relaxed skin tension lines. Results: We present several representative case examples in which a hurricane incision has been used to treat and provide closure to plantar-based calcaneal ulcers. Discussion: The use of this incision, which resembles a satellite view of a hurricane, was successful in achieving a desired partial calcanectomy and wound closure. This may be an additional tool in the armamentarium of the surgeon to assist in healing and amputation prevention.
PMCID: PMC2817571  PMID: 20165545

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