Limb Salvage

Christine Miller's picture
Coordination of Care

By Christine Miller, DPM, DMM, PhD, FACCWS

One of the gratifying aspects of being a wound care physician is the ability to develop such rich relationships with our patients. The frequent and consistent contact with the same provider lays a strong foundation of open communication and trust. I work in an urban safety net hospital’s ambulatory care center, which sees a high volume of high-acuity patients. It is not uncommon for me to see patients with venous leg ulcerations with concomitant uncontrolled hypertension or diabetic foot ulcerations secondary to uncontrolled blood glucose levels. Patient education is a vital part of my clinical encounters, particularly focusing on the systemic nature of wound healing. I always emphasize that while we are treating your wound, it is the full body well-being that is needed for ultimate success.

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Aletha Tippett MD's picture
doctor giving patient hope

by Aletha Tippett MD

I have written about so many things over the past years… Maybe now is a good time to announce that I am writing a book called Hear Our Cry, an autobiographical story about 20 years of wound care and limb salvage. The process has had quite an impact on me, reviewing all the pictures and notes from my wound patients from the past two decades.

Mary Ellen Posthauer's picture

by Mary Ellen Posthauer RDN, CD, LD, FAND

I was fascinated by the incredible amount of money that was donated to various organizations on December 2nd – the day declared as a National Day of Giving. This movement started in 2012 by the 92nd Street Y and the United Nations Foundation as a response to the commercialization of Black Friday and Cyber Monday.

This prompted me to Google wound care foundations and indeed there are numerous organizations seeking donations to further research and education endeavors. Here are a few that I found.

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Aletha Tippett MD's picture
grief

by Aletha Tippett MD

The topic of grief and bereavement is near to my heart right now as I just lost my beloved therapy dog, Barney, suddenly to hemangiosarcoma after years of service. He was an important and valued part of our healing community and will be mourned for a long time.

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Aletha Tippett MD's picture

by Aletha Tippett MD

What? How can limb salvage be heartbreaking? Isn't it great to save a leg and a life? Of course, that is all wonderful and is what keeps you going in this very difficult field. What is heartbreaking is when you have worked so hard and are winning the game, only to have your patient swooped away by others and the limb is amputated without ever being contacted or consulted.

Mark Hinkes's picture

by Dr. Mark Hinkes, DPM

Twenty first century technology is helping people with diabetes to heal foot ulcers. An Australian colleague, for example, is developing an application that reminds people with diabetes to control their blood sugars with prompts and instructions, and allows them to upload a picture of their wound for their podiatrist to evaluate.

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Aletha Tippett MD's picture

by Aletha Tippett MD

In considering this question as to whether amputation can be palliative, let’s keep clear that these are two separate subjects that sometimes interact. It is key to always keep our goals in mind. What is the goal in palliative care? The goals are to provide comfort, relieve pain, prevent infection, and improve or maintain quality of life. These goals are always to be in concert with the desires and wishes of the individual patient.

Laurie Swezey's picture

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

Diabetic foot ulceration can lead to significant morbidity and mortality and is probably one of the most-feared complications of diabetes. Loss of limb (amputation) is a frequent outcome of diabetic foot ulceration.

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