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Michael Miller's picture
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By Michael Miller DO, FACOS, FAPWCA

RAMBLINGS OF AN ITINERANT WOUND CARE GUY PT. 4

I willingly confess that I enjoy being a maverick. Of course, at age 52 with two cats, a wonderful wife of 27 years, and two daughters (this order in no way implies favoritism), that term seems to be a bit of a stretch. As a wound care clinician and scientist, I am always on the lookout to find that new innovative dressing, technique, or technology that will help my patients just a little bit more than the next guy. I believe the trade term for my type of psychosis is called “Early Adopter.” I prefer to think of myself in terms of the little kid we all knew who had to have the newest toy first.

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Aletha Tippett MD's picture
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By Aletha Tippett MD

For a physician or nurse in wound care, the primary thing to remember is this: you are not just seeing a wound, you are seeing a person who has a wound. Do not lose sight of this human and their humanity. Always look at the whole picture of your patient, not just their wound. Find out what is important to them and for them. Your patient might tell you, “Doc, I don’t care about the wound, I just can’t stand the smell,” or “Doc, just cut my leg off because I can’t stand the pain.”

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Karen Zulkowski's picture

Part 1 in a series discussing the process of litigation in patient care lawsuits

By Karen Zulkowski DNS, RN, CWS

Hopefully none of you will be involved in a lawsuit over patient care. However, pressure ulcers are the second most common lawsuit (wrongful death is #1) and 50% of patients with a pressure ulcer in the hospital go to a nursing home. That is 3 times the rate of any other reason for nursing home placement. To complicate matters, patients with pressure ulcers frequently go back and forth between the hospital and nursing home as additional medical complications arise and the patient’s condition deteriorates.

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Thomas Serena's picture

By Thomas E. Serena MD, FACS, FACHM, FAPWCA

From the third floor patio of the Foreign Correspondent’s Club (FCC), the evening breeze is a welcome respite from the sweltering heat of Phnom Penh’s hospital wards. An assortment of barges and boats strung with neon lights drifts along the Mekong Delta. This location, made famous by the movie the Killing Fields, has become the meeting place for NGOs (non-governmental organizations) and volunteers of all sorts. Nightly, we would share our tales of life and death in Cambodia’s capital city. A recurring theme was the lack of active ingredients in medicines purchased at local pharmacies. A trio of Brits complained that it was far worse in other resource poor nations. I was appalled that someone would reduce the dose of a medicine for economic gain.

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Laurie Swezey's picture

By Laurie Swezey RN, BSN, CWOCN, CWS, FACCWS

Diabetic foot ulcers are one of the most dreaded complications of diabetes, and represent a significant cause of morbidity and mortality. It is estimated that a lower limb is sacrificed every 30 seconds somewhere in the world due to diabetes, and that diabetes is the reason for almost 50% of non-traumatic amputations of the lower leg throughout the world. Considering these facts, proper management of diabetic foot ulcers is of paramount importance.

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Mary Ellen Posthauer's picture

By Mary Ellen Posthauer RDN, CD, LD, FAND

The role of protein in wound healing has been documented in many studies with the focus on offering high calorie, high protein supplements in addition to diet. Protein is responsible for cell multiplication, repair, and synthesis of enzymes involved in wound healing. Protein supplies the binding material of skin, cartilage, and muscle. In wound cases, research supports offering protein above the traditional 0.8 grams/kilogram of body weight recommended for the healthy adult.

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Glenda Motta's picture

By Glenda Motta RN, MPH

Medicare is now beginning round two of the Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Competitive Bidding Program. Congress mandated this through the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (MMA). This applies to a number of items used by beneficiaries on an outpatient basis. The intent is to reduce beneficiary out-of-pocket expenses and save the Medicare program money, but still ensure beneficiary access to quality items and services.

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Michael Miller's picture

By Michael Miller DO, FACOS, FAPWCA

RAMBLINGS OF AN ITINERANT WOUND CARE GUY PT. 3

I just had the most amazing thing happen: I received a letter from my hospital informing me that they were considering creating an Open-Heart Surgery Center. Other than myself, there will be Radiologists, Family Practitioners, and Pathologists all participating in the program. In an effort to share the proceeds from participating in this venture, all participants will be offered four hour time periods throughout the week in which to practice this new specialty. Recognizing that we are not experts in this area of medicine, each of us will be required to take a one-week course in open-heart surgery before being able to hang our shingles outside the clinic.

Ron Sherman's picture

By Ron Sherman MD, MSC, DTM&H

Although maggot therapy has been with us for nearly 100 years, many wound care specialists are still unfamiliar with it. Therefore, we should step back and briefly review the history and general concepts underlying maggot therapy, before delving into the recent scientific literature on this method of biotherapy.

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Aletha Tippett MD's picture
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By Aletha Tippett MD

In my work with wounds, I frequently find the absence of a diagnosis of ischemia, or worse, I find a misdiagnosis. Ischemia is caused by severe obstruction of the arteries, which seriously decreases blood flow. If the arteries are in the heart, you will find a heart attack. If the arteries are in the brain, you will find a stroke. In the skin, you will find a wound.