Scottsdale podiatrist develops foot-ulcer treatment

Amniotic fluid is used to close up, heal infected wounds

Appeared in: AZ Central

By: Lisa Kennell

Published on: 01/18/12

A Scottsdale podiatrist has developed a treatment for diabetic foot ulcers that could prevent amputation and other health problems.

The treatment is the brainchild of Dr. Bruce Werber of InMotion Foot & Ankle Specialists, who has practiced podiatry for 32 years. Werber gets the open, infected wounds to close by injecting them with amniotic fluid.

In the last year, he said, most people whose ulcers were not responding to treatment saw their wounds heal completely using this new treatment.

Larry Minor, 50, of Phoenix, started seeing Werber more than a year ago to deal with Charcot foot, a condition in which the heel collapses. A bone broke through Minor's heel, leaving a wound he struggled with for three years before it closed.

Werber tried to close Minor's wound with surgery and skin grafts, but it kept reopening. So he decided to inject amniotic fluid into the wound six months ago, and the wound healed in three months.

"He went out of his way to help me," Minor said. "He is extremely aggressive in finding new ways to treat wounds."

Werber talked recently about the new treatment.

Question: What is a diabetic ulcer?

Answer: It happens when diabetics, either with type 1 or type 2, lose sensation in their feet.

It's called neuropathy, and it happens gradually and unconsciously, so they really don't know this is happening.

They may get a cut and not know it. That little cut can get infected, and the wound can erode through the skin and down into the bone. They're very serious.

Any diabetic ulcer, even the smallest, can become a life-threatening event.

Q: What is the treatment you've developed for diabetic foot ulcers?

A: We now have amniotic membrane and fluid that is cryopreserved.

So it can be used on anybody at any time and anywhere and morselized so it can be injected.

We don't have to have a live birth to collect it, and it can be harvested in very clean, sterile conditions.

We inject it in and around the wound, and it enhances the healing.

Q: How does the amniotic membrane work to heal wounds?

A: In our study of 20 patients, they all had wounds that were unresponsive to other more traditional treatments. We started to inject the amniotic membrane around the wounds and within days they started to close.

The membrane has mesenchymal stem cells, which have all of the nutritional materials the tissue needs to heal. It stimulates the body very rapidly and very aggressively to start to create normal, healthy tissue.

Q: How successful has this treatment been?

A: Of the 20 people in our study, all of their wounds have responded and 90 percent have closed in the last year.

A couple of very larger wounds that cover the whole portion of the lower leg take a while to close, but with more traditional therapies, they may never close.

Everybody had progression, which is pretty remarkable for any medication.

Q: Are there any risks to injecting amniotic fluid?

A: There have been no adverse effects even when doctors have tried to insight a reaction.

Q: Will most insurance companies cover this treatment?

A: Not yet. We've only been using this type of material for this type of wound in the last year but with a very high success rate. It's going to be a couple of more years before insurance companies accept this.

Bruce Werber, DPM, graduated from the California School of Podiatric Medicine (CSPM), formerly known as California College of Podiatric Medicine (CCPM), in 1980.


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