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I have received May APMA News issue (vol.26.n.5) where there is an article about Dr. Balkin and foot silicone injections.
I wonder if there is someone on this forum who have experience due to this subject. There are articles published on this subject:
The Histologic Host Response to Liquid Silicone Injections for Prevention of Pressure-Related Ulcers of the Foot J Am Podiatr Med Assoc 94(6): 550–557, 2004)
The effect of silicone injections in the diabetic foot on peak plantar pressure and plantar tissue thickness: a 2-year follow-up.Arch Phys Med Rehabil. 2002 Jul;83(7):919-23.
And Dr. Boulton from Manchester (one of the co-autors from this last article) have been using this treatment for various years.
I would like to know further on this subject, if it would be possible regarding to personal experiences.
I think that this treatment have a good potential for a large number of foot conditions.
Thanks for your response. I am afraid only Dr. Balkin and Dr. Boulton have experience due to this subject.
The company who produce injectable silicone is, according to APMA news, Richard-James Inc. (http://richard-james.com/page0002.htm). They call this product Podisil. Although it will approve only in EU.
BACKGROUND: Since 1964, the author has investigated injectable liquid silicone as a soft tissue substitute for the loss of plantar fat. This form of fatty tissue depletion over the sole is closely linked to a common painful weight-bearing foot disorder, metatarsalgia, and to painless diabetic foot ulcers.
OBJECTIVES: To present the history of injectable silicone, corporate interest, individuals who helped pursue approval, its misuses, and events that have delayed its availability.
MATERIALS AND METHODS: Dow Corning Corporation's 360 Medical Fluid of 350 centistoke was injected beneath corns and calluses in 1585 patients. Diabetic neuropathic foot ulcers were injected after healing in an effort to prevent their recurrence. Surgical and postmortem specimens were gathered for histologic analysis.
RESULTS: There was no evidence of significant adverse response in long-term clinical follow-up. Silicone specimens studied by two departments of pathology found no inflammation, infection, allergy, or granulomas.
CONCLUSIONS: Medical Fluid silicone appears to be safe, effective, and stable biomaterial for treating weight-bearing loss of plantar fat. Trademarked PodiSil (Richard-James Inc., Peabody, MA, USA), a 350-centistoke injectable silicone has been approved for marketing in Europe for the prevention of diabetic foot ulcers.
There is a companyy called Q-Med.com selling the Restylane range for injection and they state that Perlane has the best results and has previouisly been injected into the ball of the foot. Setting up an account is quite straightforward ring 01737 77 55 03
This is classed as a medical device not POM.
I have received May APMA News issue (vol.26.n.5) where there is an article about Dr. Balkin and foot silicone injections.
I wonder if there is someone on this forum who have experience due to this subject. There are articles published on this subject:
The Histologic Host Response to Liquid Silicone Injections for Prevention of Pressure-Related Ulcers of the Foot J Am Podiatr Med Assoc 94(6): 550–557, 2004)
The effect of silicone injections in the diabetic foot on peak plantar pressure and plantar tissue thickness: a 2-year follow-up.Arch Phys Med Rehabil. 2002 Jul;83(7):919-23.
And Dr. Boulton from Manchester (one of the co-autors from this last article) have been using this treatment for various years.
I would like to know further on this subject, if it would be possible regarding to personal experiences.
I think that this treatment have a good potential for a large number of foot conditions.
Regards,
Javier
Javier
Have you had any success with the question of silicone injections which you asked about in 2005. I too feel there is a good potential for a large number of foot conditions but little info available
Have you had any success with the question of silicone injections which you asked about in 2005. I too feel there is a good potential for a large number of foot conditions but little info available
Ross,
I have not received any feedback from the company. Also, as you have stated there is few info available. Perhaps, it has not been approved within EU.
Thanks Javier for our quick reply. This is the first port of call for this perhaps underrated or never used treatment. The little search I have done has told me that silicone has been used on other parts of the body for years and used daily for invasive procedures in hospitals. So why are we not using silicone injection for treatment of foot problems. I can't seem to find an answer yet.
Personally at this time I am thinking an injection of silicone under a decreased fat pad has got to be of benefit, why are we padding up and making devices that don't always work and or end up in the cupboard or bin. where do I go now? I don't think legisalation is an issue because it is used as I said extensivley in hospitals of Australia.
and with private plastic surgeons to implant almost anything you want for cosmtic purposes. as mentioned I would like to be able to assist some of my patients with decreased fat pad to improve mobiltiy and hopefully decrease pain and discomfort but I guess you are aware of all this
cheers Ross
Hi everyone
About this subject i have found a company from the USA that produces Silicone injections. The product name is InnoPad and it is sold in the EU also. I will post here there contacts and the product info, hope it healps.
Cheers
André Ferreira
Manufacturer’s Address:
Extremity Innovations, Inc. 8390 Wolf Lake Drive, Suite 116
Bartlett, Tennessee 38133 U.S.A.
(901) 753-4642 www.extremityinnovations.com
Authorized Representative in Europe:
(Regulatory affairs only)
Emergo Europe
Molenstraat 2513 BH The Hague
The Netherlands
Tel: (31) (0) 70 345-8570
Fax: (31) (0) 70 346-7299
So many patients have fat pad atrophy, prominent metatarsal heads, and complications relative to these conditions---
We have an Orthopedic Surgeon here who is doing a study with tendo-Achilles lengthening procedures and how this contributes to healing forefoot/plantar ulcers.
How can you keep the material localized when it is injected as a liquid silicone? What about all the adverse effects seen in breast implants that failed/leaked back in the 1990's?
I've not seen the injectable version of silicone for fat pad atrophy, but a mentor of mine during fellowhip at Yale wanted to try using higher-strength versions of breast implants in the met heads and possibly the plantar heels of patients with severe fat pad atrophy...
I haven't thought about it for a long while- seems to me the difficult portion would be the method of transplantation- which tissue planes to use, issues with keeping the implants in place...under such high pressures and shear forces.
The idea makes sense to me, but a special version of the implant would need to be made.
...Comments?
-John
__________________
Dr. John G. Fasick II
Clinical Insructor, LSU School of Medicine
Advanced Foot & Ankle Center of East Jefferson footankledoc2@gmail.com
I am considering silicone injections for a particularly nasty chronic Hd.
My question is to anyone that may have knowledge where I may purchase liquid silicone for injection in the United Kingdom. All information greatly appreciated
I am considering silicone injections for a particularly nasty chronic Hd.
My question is to anyone that may have knowledge where I may purchase liquid silicone for injection in the United Kingdom. All information greatly appreciated
Geoff
You should look ate the thread that i have posted in this post at 26th May 2009, 12:58 AM .
I know that this company is marketing silicone injections for podiatris in the EU.
Hope it helps
Courses for silicone injection are readily available in the UK. The one I attended was by Ian Reilly and Stuart Metcalfe, Pod Surgeons, of EliteEC, although another one is mentioned in the current Podiatry Now.
There is a specific method to the injections as it has to stay where you put in and not migrate, so I would advise you to attend a course.
The product is available from Osteotec, 01202 487885.
I work with Prof Boulton and the guy who is doing it is Dr Frank Bowling. He actually learnt all his stuff from Mr Sturat Metcalfe a Podiatric Surgeon who owns www.elitece.co.uk
The majority of their work is with Diabetic patients currently. Indeed a saw them administer a course of 4 injections over a 2 month period. From the questions i asked its not just a matter of.. lets stick a load of silicon in someones foot and whey!!, it takes a more structured approach of gradually building up the thickness. What i also learnt is that its important to consider foot function as well. I performed the plantar pressure analysis of this lady which showed late stance pronation so she sheared across the whole of her met heads.. If the forces continued to do this what would be the effect on the silicon? I still dont think they have any work published on this aspect.
Please feel free to PM me and i can give you Mr Bowlings e-mail address if you are really interested in this? Otherwise you maybe best checking out their site.
I have been unable to get a source for the silicone in the US-
have been referred to a company in Tennessee, but no reply-
anyone know of a source in the USA?
-John
__________________
Dr. John G. Fasick II
Clinical Insructor, LSU School of Medicine
Advanced Foot & Ankle Center of East Jefferson footankledoc2@gmail.com
Hello Gibby
Like I told Geof you should check out my post (26th May 2009, 12:58 AM) this company is from the US send a email they repli very fast...
Hope it healps
André
Effect of growth factors in combination with injectable silicone resin particles on the biological activity of dermal fibroblasts: A preliminary in vitro study.
Jennings JA, Crews RM, Robinson J, Richelsoph K, Cole JA, Bumgardner JD, Yang Y, Haggard WO. J Biomed Mater Res B Appl Biomater. 2009 Nov 10.
Quote:
Injections of silicone fluid have been clinically evaluated to treat and prevent foot ulcers due to diminished plantar fat-pad in neuropathic diabetics. The objective of this study was to determine preliminary in vitro effects of an injectable form of silicone resin particles in combination with growth factors to determine the suitability of this potential therapy for prevention of diabetic foot ulcers. Basic fibroblast growth factor (bFGF), epidermal growth factor (EGF) and platelet-derived growth factor (PDGF-BB) were added to monolayer culture along with silicone resin particles (12 mum average diameter). Growth factors were also combined as follows: bFGF+PDGF-BB, EGF+PDGF-BB, and bFGF+EGF. Growth factors alone and in combination increased fibroblast proliferation, but the presence of particles did not significantly affect cellular proliferation. The addition of particles significantly increased fibronectin production 117% in the control group and 151% in the PDGF only group. Collagen production was increased with exposure to EGF and growth factor combinations, but the presence of particles did not lead to any significant differences, except an 81% increase in the bFGF group. These preliminary results suggest that a combination of PDGF and bFGF may be effective in stimulating proliferation and matrix production around injectable silicone resin particles to generate a fibrous tissue pad to alleviate the abnormal distribution of high pressures that contribute to diabetic foot ulcer forma
So, in two weeks time, no one has a take on this technique to treat fat pad atrophy with the implantation of an a c e l l u l a r human dermal allograft (GRAFTJACKET® Regenerative Tissue Matrix, Wright Medical Technology, Inc., Arlington, TN) as a tissue augment?
Has anyone even heard of the procedure and/or product (Graftjacket)?
Cheers,
CC
The Following User Says Thank You to Corn Cutter For This Useful Post:
So, in two weeks time, no one has a take on this technique to treat fat pad atrophy with the implantation of an a c e l l u l a r human dermal allograft (GRAFTJACKET® Regenerative Tissue Matrix, Wright Medical Technology, Inc., Arlington, TN) as a tissue augment?
Has anyone even heard of the procedure and/or product (Graftjacket)?
from what i have seen / heard the graft jacket is being used by for cosmetic reasons ie so the ladies can wear their jimmy choos.
I have no problem with this. I think plantar fat pad augmentation with either the graft jacket or injectable silicone / dermal fillers has a place which is yet to be fully established in the main stream. I know of a few podiatrists (in the UK) using this both in the NHS and private (mostly aesthetic podiatry) including harley street.
from what i have seen / heard the graft jacket is being used by for cosmetic reasons ie so the ladies can wear their jimmy choos.
I have no problem with this. I think plantar fat pad augmentation with either the graft jacket or injectable silicone / dermal fillers has a place which is yet to be fully established in the main stream. I know of a few podiatrists (in the UK) using this both in the NHS and private (mostly aesthetic podiatry) including harley street.
Are you saying these podiatrists are actually treating fat pad atrophy with the implantation of an a c e l l u l a r human dermal allograft (GRAFTJACKET® Regenerative Tissue Matrix, or just the injectable silicone / dermal fillers?
I know Orthopedic surgeons use the graft jacket for difficult rotator cuff surgical repairs--- I will have to research the product's use in our field.
Interesting idea.
-John
__________________
Dr. John G. Fasick II
Clinical Insructor, LSU School of Medicine
Advanced Foot & Ankle Center of East Jefferson footankledoc2@gmail.com
I have been using dermal fillers her in the UK for about 5 years now and have had a great deal of success, most patients are very happy and return for more treatments.
I have not used silicones as not altogether happy with using permanent fillers, I don't know of any UK Plastic Surgeon that uses them now and I know quite a few most of them have tried permanent fillers in the past and have not been happy with the outcomes hence their attitudes to them now. I have taken their experiences on board and steered clear of these types of filler, the literature in asthetic journals is not favourable either.
Not to say it woudl not work I just don't want to risk the problems if it does not if however the surgeons in the UK want to use silicones I am sure they at least will be able to be better equiped if problems occur.
I would be more than happy to speak with anyone that is interested to learn more, personal message me or send a message via my website www.pillowsforfeet.com
An interesting thread, however courses for Silicone fillers are still being promoted as recently as this month. As I am interested to learn about these diffferent methods, perhaps you could expand on why you believe this is better than Silicone?
Do you run courses or are you willing to offer a tutorial from your clinic?
Foot silicone injections
Hybrid Mode
