Physical Therapy

By the WoundSource Editors

Diabetic foot ulcers (DFUs) continue to be a major problem, causing patient suffering, burden, infections, and high mortality. The cost of DFU treatment was estimated at $1.3 trillion globally in 2015. Despite evolving advanced wound care technologies through the years, DFUs continue to be among the most challenging chronic wound types.

by Karen Bauer , NP-C, CWS

In my recent WoundSource webinar on management strategies of venous leg ulcers (VLU), I discussed the complex pathophysiology of VLUs and procedural interventions that can help them reach closure.

By Janet Wolfson, PT, CLWT, CWS, CLT-LANA

My current job as wound coordinator has pulled me into the world of incontinence and the many disciplines that care for people challenged by this disorder. I was previously acquainted with the therapy side as I worked with therapists certified in pelvic floor therapy. My work with venous edema acquainted me with medications that caused continence-challenged people to resort to absorbent adult briefs. As I work more closely with physicians, I am more familiar with medications to support weakened or sensitive pelvic muscles and nerves. On the nursing side, I have researched support surfaces, incontinence pads, and barrier creams. I see patients and occupational therapists working together to regain continence independence through problem-solving mobility issues.

By Janet Wolfson, PT, CLWT, CWS, CLT-LANA

As I was commuting in to work a few Saturdays ago, I listened to The People’s Pharmacy on NPR. The topic was non-pharmacological treatment of infection, so being a wound care professional, I immediately started thinking of the ways I treat wound infections. In addition to oral, topical or IV antibiotics, as a PT there are modalities available to me to treat wound infections. The advantage of using these modalities is that treatments are effective across a broad spectrum of bacteria without the risk of resistance. Really! These treatments include ultrasound, electrical stimulation and laser or light-emitting diode (LED) therapy.

By Janet Wolfson, PT, CLWT, CWS, CLT-LANA

If you read my last blog on therapeutic interventions to stimulate wound healing, then you may recall the asset that a lymphedema trained therapist can be to your wound care department. A recent patient at the inpatient rehab facility where I am currently the Wound Care Coordinator illustrates this wonderfully.

By Janet Wolfson, PT, CLWT, CWS, CLT-LANA

I know we have all had those patients with diagnoses that impair their wounds forming granulation tissue to fill wound depth. Perhaps there are comorbidities such as diabetes, peripheral artery disease or malnutrition. Skin flaps, cellular and/or tissue-based products for wounds, and hyperbaric oxygen therapy are alternatives, but not every patient can tolerate surgery or a hyperbaric chamber, has a shallow enough wound or enough arterial supply to make these other options successful.

By Janet Wolfson, PT, CLWT, CWS, CLT-LANA

A story was related to me from someone living in a rural part of the US. A family member was in need of ongoing wound care. They were referred to a specialist who was of all things… a physical therapist! This is a response with which I am quite familiar. I have been referred to by a number of "titles" including Wound Coordinator, Wound Specialist, 'Skin Lady', and Wound Nurse, to name a few. If you scan my byline, I do have a good alphabet soup following my name, but to many, "PT" is a surprise.

By Robert Striks, Special Writer, Encompass HealthCare & Wound Medicine

There's a funny scene in the Marx Brothers movie, "Horse Feathers," where Chico tells Harpo how to escape from the room they are locked inside by using a rope. Chico instructs Harpo to tie one end of the rope to the bed and then throw the other end of the rope out the window. "Tie on the bed, throw the rope out the window," he repeats. Haplessly, Harpo takes the tie he was wearing around his neck, places it on the bed and then throws the entire escape rope out the window.

By Aletha Tippett MD

In 1771, Luigi Galvani discovered that the muscles of a frog leg contracted when touched by a spark. This spawned the beginning of our understanding of the relationship between electricity and electrical stimulation and its effect and use on the human body. One thing that is often overlooked when caring for wounds is the impact that electricity can have on wound healing. It is used in the form of electrical stimulation, most often applied by a physical therapist. In her wonderful book, Wound Care: A Collaborative Practice Manual for Health Professionals, Dr. Carrie Sussman provides the rationale and procedures for using electrical stimulation to promote wound healing.

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

I had the honor of lecturing to an audience of mostly European physicians at the M.I.L.A.N. Diabetic Foot Conference this past February in Milan, Italy. My session this year focused on our current and ongoing research in point-of-care diagnostics. To date, we have enrolled more than a thousand patients in a dozen clinics across the United States. All of these trials led to the development of the first commercially available wound diagnostic, WOUNDCHEK (Systagenix, Gargarve, UK), approved in Europe last year (it has not yet received FDA clearance for use in the US). A revolutionary product, I imagined that it would have received rapid, wide-spread acceptance among my European colleagues. At the end of the presentation I asked for a show of hands: “How many of you are using the test in your clinics or hospitals.” In an audience of nearly one hundred, only three attendees raised their hands.