Amputation

Christine Miller, DPM, PhD, FACCWS

A limb salvage program aims to prevent major amputations and thus improve patients' quality of life and overall longevity. Despite the efforts of a multidisciplinary team approach, amputation prevention remains a challenging endeavor.¹ Providing both physical and socioemotional guidance for patients undergoing a major amputation is crucial for recovery. A multifaceted approach to post-amputation care may seem like a relatively modern concept, but it has deep roots in earlier civilizations.

By WoundSource Editors

Diabetic foot ulcers (DFUs) are open sores or wounds caused by a combination of factors that include neuropathy (lack of sensation), poor circulation, foot deformities, friction or pressure, trauma, and duration of diabetes with complication risks. DFUs occur in 34% of people with diabetes, and approximately 14% to 24 % of patients with diabetes who develop a DFU will require an amputation.

By Christine Miller, DPM, PhD

Benjamin Franklin famously stated, “An ounce of prevention is worth a pound of cure.” This statement was made in reference to the importance of fire prevention in 18th century Philadelphia, but it aptly applies to modern diabetic limb salvage. The multidisciplinary model for amputation prevention has been in place now for almost two decades, but how far have we really come? Recent literature suggests that there has not been a significant decline in reamputation rates for diabetic patients despite the team approach to care. Diabetes is a complex and aggressive disease that affects multiple organ systems and robs patients of sight, sensation, limb, and quality of life. Treating such an aggressive disease is challenging, to say the least, and often the desired outcome is not achieved.

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 the WoundSource Editors

Necrotic wounds are characterized by devitalized, or dead, tissue. Necrosis may be caused by malignancy, infection, trauma, ischemia, inflammation, or exposure to toxins. It may also be caused by improper care of an existing wound site. Devitalized tissue has no blood supply, and its presence prevents wound healing. It is necessary for necrotic tissue to be removed to allow wound healing to occur.

By Lydia Corum RN MSN CWCN

The times are changing in the world of wound care. There used to be a time when there were no problems with reimbursements, as long as the doctor wrote the order. Today, the Centers for Medicare & Medicaid Services (CMS) regulations confuse clinicians and make the world of healing wounds much more difficult. The changes are in the area of denials with not enough information given for choosing dressings, use of negative pressure therapy and hyperbaric oxygen therapy. Are all these changes needed? Why are these changes happening? What can hospitals and wound clinics do to make things better?

By the WoundSource Editors

Pressure injuries require complex care. They can be incredibly painful for patients, and they represent an enormous financial burden on the health care system. Nationally, pressure ulcers cost between approximately $9.1 and $11.6 billion annually to treat. A subset of these patients includes those who are particularly prone to developing pressure ulcers as a result of comorbid conditions. This subset includes patients who may have cognitive disabilities, those who have a spinal injury or have undergone an amputation, and bariatric patients.

By Cheryl Carver, LPN, WCC, CWCA, CWCP, DAPWCA, FACCWS, CLTC – Wound Educator

The challenges for all clinicians associated with substance abuse and addiction are at an all-time high. We are seeing more and more overdoses and skin and wound issues. There needs to be less judgment and more education. Not every person with substance abuse issues is addicted due to a poor choice. Reasons for abuse can be related to unmanaged mental illness, self-medication and family genetics, to name a few. Compassion is lacking for this group of folks. I have seen it firsthand. This topic hits close to home as I have a son in recovery. This problem is an epidemic and needs to be talked about more. I live in Ohio, and we are one of the top five states for heroin and methamphetamine (meth) abuse.

By Cheryl Carver, LPN, WCC, CWCA, CWCP, DAPWCA, FACCWS, CLTC – Wound Educator

As a veteran of the U.S. Army, and having a grandfather who was a U.S. Army combat medic, I have always had an interest in combat wound care. Wound care has evolved immensely throughout the years in the military arena. The treatments used as far back as the fifth century B.C. were inconceivable. Examples are keeping wounds dry, wound irrigation with water and wine, burning oil into infected wounds, and topicals such as egg yolks, rose oil, and turpentine applied to the wound bed. Odor was controlled with bags of lavender at the soldier’s bedside.

Temple University School of Podiatric Medicine Journal Review Club
Editor's note: This post is part of the Temple University School of Podiatric Medicine (TUSPM) journal review club blog series. In each blog post, a TUSPM student will review a journal article relevant to wound management and related topics and provide their evaluation of the clinical research therein.