Supplement overview

Abstract

Supplements to mainstream scientific journals come in several varieties. Proceedings of scientific meetings of special interest, reviews of specific topic areas, and compendia of information about new drugs or techniques are common forms for the content of supplements. Most of these appeal to a very limited audience. It is, therefore, a particular pleasure to review the articles in this supplement to the American Journal of Surgery prepared by Dr. Wieman and his colleagues. This group of clinicians and investigators has successfully gone beyond the usual constricted view of supplements to supply a comprehensive update on the pathogenesis, pathophysiology, and care of a significant clinical problem—nonhealing diabetic ulcers of the lower extremity. In my view, they have succeeded in providing a concise and readable look at the basic science, clinical origin, and medical and surgical care of this entity. The educational value of this presentation is, as a consequence, substantial. In addition, there is a comprehensive review of the development and testing of one growth factor that appears to be of value in the care of diabetic foot ulcers, becaplermin (recombinant human platelet-derived growth factor-BB, or rhPDGF-BB), which promotes the development of granulation tissue and has led to improved healing in clinical trials. This agent has the approval of the US Food and Drug Administration for clinical use and is marketed under the brand name Regranex (becaplermin) Gel (McNeil Pharmaceuticals, Raritan, NJ).