Researchers from Washington University in St. Louis are studying whether Botox -- a poison commonly used to treat wrinkles -- can help patients with foot ulcers.

Botulinum toxin type A could be the wonder drug of the 21st century. It's been used for wrinkles, muscle spasms and even Tourette syndrome. Now Botox may save limbs from amputation.

Each year, foot ulcers lead to more than 82,000 amputations. They’re a devastating complication of diabetes.

"Every time you have an ulcer, this is just one more opportunity to develop a limb-threatening infection that might require an amputation," Jeffrey Johnson, M.D., an orthopedic foot and ankle surgeon from Barnes-Jewish Hospital at Washington University School of Medicine in St. Louis, said.

Researchers at Washington University say healing the ulcers is tough, but keeping them healed is tougher.

"The problem is the recurrence rate is very high," Johnson said. "Within the first month after healing these ulcers ... 60 percent or 80 percent of patients will re-ulcerate during that time."

Wounds are most common on the ball of the foot, and the pressure on wounds is highest when a person walks. That’s where Botox comes in.

"What the botulism will do is weaken that muscle, the muscle that pushes you forward during walking, and so then you can’t develop the high pressures under the front of your foot," said Mary Hastings, a physical therapist at Washington University who is leading the study.

In the study, doctors will inject Botox in six different places in the calf muscle. Then, they’ll cast it. They know the Botox will weaken the muscle, and they hope that’s enough to keep the wounds healed.

"The more time you spend without a sore on the bottom of the foot, the less chance you have for an infection that will develop into the potential for a need for an amputation," Hastings said.

The study has already started enrolling patients.

Botox is already approved by the FDA to treat other medical conditions. Hastings says this is the first time Botox has been used for foot wounds.

There are more than 18-million diabetics in the U.S.. Foot ulcers are only one of the many health complications from the disease.

(Source: King 5 News, August 7, 2005)