Lower Diabetic Foot Ulcerations with Orthotic Devices: Article

http://lowerextremityreview.com/issues/august/amputation-reulceration-rates-fall-after-two-years-of-orthotic-therapy

ShearBan: Great to Reduce Friction at the Bottom of the Foot

When trying to eliminate friction from the bottom of the foot, especially in cases of ulcerations, scars, calluses, and sore points, ShearBan and Engo are 2 great products. Here I am using ShearBan, with 1/8th plastazote or memory foam, with an accommodative pad to reduce both the vertical load and the shearing load (friction) on a developing ulcer. This patient has already had toes amputated from PAD, or peripheral arterial disease, and any developing sore must be protected as well as possible. 

1/8th inch Memory foam (plastazote) from JMS Plastics to replace the shoe insert to reduce the vertical load on the sore area.

The developing sore, which has not yet ulcerated, is marked with Wet and Wild Lipstick

The shoe insert is placed into the shoe, and then the foot with the lipstick, is carefully placed. The patient is asked to walk a few feet. The first mark is always from the foot getting into the shoe, with the mark closest to the toes being where the sore is located.

A small piece of ShearBan is placed on this area on the top surface of the memory foam in direct contact with the sore area. You want to reduce the shearing force in as small area as possible since you do not want the foot sliding too much in the shoe. 

Here 1/16 inch neolon, also from JMS Plastics, is placed on the bottom surface of the pad to off weight the sore. 

Here the 2 glued sided are joined accomplishing the off weight bearing. So, with the above treatment, this shoe insert has reduced vertical load, reducing friction or the shearing force, and off weighted the sore area. One of these functions should help prevent pain and further loss of limb. 

Bad Sores: Top Podiatrist Recommends this Product

I recently sent a diabetic patient to a top wound specialist for an opinion. His recommendation to her was to use Winvivo Healing Balm. She definitely looked a lot better in the three wounds I had been trying to help her with. It can be used for superficial or deep wounds. It should not be used in the face of a possible infection. I believe the product has some great potential, but it is always trying to find out who it is beneficial for. 

http://www.winvivo.com/healingbalm.html

Wound in a diabetic after I scraped the callus and dead tissue away (called debridement). Careful debridement is always the number one treatment for these injuries/sores.

Application of Winvino to the wound bed.

Closeup of the wound bed after application of the product. I like it because it can penetrate into a wound. I love another product called Acticoat when the wound is superficial.