Alton R. Johnson Jr.'s blog

Alton R. Johnson, Jr, DPM, DABPM, FACPM, FASPS, CWSP

In this interview with Dr. Johnson, he describes the use of imaging technology in wound care and how clinicians should be aware of the way skin pigmentation may be evaluated differently/ incorrectly with these systems.

By Alton Johnson Jr., DPM, CWSP

Since my last blog post, I was fortunate enough to turn 32 years old. To many of us, turning 32 years old does not seem like much of a big deal, but as an African American man, it is, because the average life expectancy of a Black man in America is 75 years, which is the lowest life expectancy of all ethnicities in America. Essentially, in five years, I will be statistically at my midlife. It is with that mind that I work tirelessly for all patients, but I try to emphasize to African American patients the importance of wound healing, diabetes management, and overall healthy well-being.

By Alton R. Johnson Jr., DPM

It all started with a phone call at close to midnight on a Saturday night from my physician’s phoneline app. It was an established wound care patient calling me to state that his negative pressure therapy device went awry. He was requesting advice to resolve the issue. Out of these growing concerns, he stated that if there was no solution, he would be immediately reporting to our hospital emergency room, which was not his preference in such a situation. In response, I simply informed the patient it was safe to turn off the device and that I would make a home visit to him at 5 o’clock the next morning. With a sigh of relief, he agreed to the plan.

By Alton R. Johnson, Jr, DPM

I can hear it now: "Alton! Don't forget to wash your hands." That's the voice of my grandmother I hear anytime I needed to wash my hands after using the lavatory, before and after treating patients, and before eating. However, I also have the voice of my residency director in my head issuing a similar reminder. I recall one of the very first emergency room consults I had as an intern and excitedly calling her about the patient presentation. I specifically told her the wound is very pungent and malodorous. She quickly replied, with over 30 years of wound care experience, "Alton, did you wash the wound?" and that was when it hit me. I told her, "No, I did not wash the wound." She responded, "Well, call me back when you wash it; then we can better assess if it's truly infection or not." It was at this very moment I learned the very first step of wound care. This step is known as "Please Wash Your Wound!" and it is equally important for both health care providers and patients to understand the basic steps for cleaning a wound.

By Alton R. Johnson Jr, DPM

Four weeks ago, I was granted the privilege to treat a patient with type 2 diabetes with neuropathy who presented to the wound care center after developing a full-thickness pressure ulceration on the lateral aspect of her right leg as a result of an ill-fitted brace used four weeks earlier. The first clinical feature I noticed about the patient's lower extremity compared with the previous encounter was marked increased pitting edema. As a sequela of the lack of compression, the patient's lower extremity edema had increased, causing the wound to break down further in comparison with our last encounter with her. I first asked the patient why she discontinued the multipurpose tubular bandage that was dispensed and applied to her right extremity during the last visit. Her immediate response was that the home health aide had disposed of it by mistake; however, the patient stated that the aide used an available non-compressive stockinette instead.