APMA News - March/April 2019 - 28

SPECIAL WOUND CARE SECTION

WOUND CARE:

NEW FRONTIERS FOR PODIATRY
APMA Past President R. Daniel Davis, DPM, is a noted expert and
frequent speaker on the subject of wound care. He is in private practice
at Family Foot and Ankle Specialists in Bridgeport, CT, and is part of the
medical staff at St. Vincent's Center for Wound Healing in Trumbull, CT.
APMA News recently caught up with Dr. Davis to learn about the latest
developments in the field of wound care and what makes him passionate
about saving limbs and saving lives.
APMA News: What do you perceive
as the most exciting developments in
the field of wound care?
Dr. Davis: We've seen a lot of
evolution in wound care. The very
first step in the evolution was
actually a gel with a growth factor.
I remember the rep coming to my
office telling us about it, and my
associate said, "What's a growth
factor?" That happened in my
tenure in this profession! That's
when we realized there is a
science to wound healing.
28 APMA News March/April 2019

From there, collagen dressings
appeared. The collagens are a
branch of evolution all to themselves
with lots of products, and they close
wounds, but those wounds would
break down again, and the patients
would become frequent flyers in the
wound care clinic.
Next we saw live cell technology. It
was bringing faster closure, but it was
not regenerative closure. The patients
were still susceptible to breakdown. I
can remember using live cell products
on everything until Medicare said
you can't use it on exposed muscle,

tendon, capsule, or bone, and we
seemed to take a step backward.
But along came placental products, and the placental products
brought major change. You could use
them on exposed muscle, tendon,
capsule, and bone. The original
placental products were dehydrated, and they brought collagen and
residual growth factor from placental tissue into a wound. Then came
cryopreserved placental products,
followed by cryopreserved viable placental products. The latter brought
live mesenchymal stem cells, which
differentiate into muscle, tendon,
capsule, bone, stroma, fat, and skin.
They provide an opportunity for
site-specific regeneration. They also
stimulate vascular endothelial growth
factor, which promotes angiogenesis
across the wound deficit in spite of
significant vascular disease.



APMA News - March/April 2019

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APMA News - March/April 2019 - Cover1
APMA News - March/April 2019 - Cover2
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APMA News - March/April 2019 - Contents
APMA News - March/April 2019 - 9
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APMA News - March/April 2019 - Cover3
APMA News - March/April 2019 - Cover4
APMA News - March/April 2019 - A1
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