Here is a link to my presentation so far:
https://docs.google.com/presentation/d/1ekyxZNbTybRA82iFaXKhwl89mAH1mGokmrBbnLyzwm4/edit?usp=sharing
I am not quite finished with it yet, so I will post another entry next week with my finalized presentation.
I will also be going in next week for one more week because I missed a few days last week.
Monday, April 25, 2016
Friday, April 15, 2016
Week 10
Hello there!
Like last week, I did not go in to the clinic much this week. I got back Tuesday from my trip to Virginia, and Dr. Stein will be out of town this Thursday and next Monday. I was able to go in on Wednesday with Dr. Weiland, and I saw a few memorable patients, which I will talk about later in this post.
Because I was not able to go into the clinic much, I am almost finished with my analysis! I have yet to compare the data that I have collected with national data, but I calculated the percent closure of 10 wounds from different patients from visit to visit and the percent closure over the course of about 3 months. I also calculated the average percent closure over 3 months from all 10 patients. Although I initially had no idea how to use Excel, with the guidance of Mr. Loudenslagel, I realized that you can plug in a formula into a certain "cell" and copy and paste it to adjacent cells. This greatly increased my efficiency. Instead of using a calculator to calculate the percent closure from visit to visit and recording each data point, I simply inserted the formula ((Y1-Y2)/Y1)*100)-- the percent change formula. I was then able to copy the relationship between Y1 and Y2, and paste it to another set of data points. However, I did encounter one obstacle : I have an extreme outlier in my pool of data. And, as we've learned in Statistics, this would cause my study to be statistically insignificant. When I return to the clinic next week, I hope to find another patient to use, but for now I've calculated the average percent closure over 3 months for all 10 patients with and without the outlier.
The most memorable patient I saw this week was certainly a decubitus ulcer. These are most commonly known as a pressure ulcer or a bed sore. Decubitus ulcers are caused by prolonged pressure on a certain area of the body that causes damage to the tissue. So far the pressure ulcers I've seen are on the ankle or foot somewhere, usually in diabetic patients. They are also usually not as severe as other types of wounds.
The patient I saw had an incredibly severe decubitus ulcer. It was located on his lower back, and, Dr. Weiland told me that it used to be so severe that you could see the entire pelvic bone in the wound. Although it had apparently improved since last visit, it was still extremely large.
Hopefully next week I can finally finish my analysis!
Like last week, I did not go in to the clinic much this week. I got back Tuesday from my trip to Virginia, and Dr. Stein will be out of town this Thursday and next Monday. I was able to go in on Wednesday with Dr. Weiland, and I saw a few memorable patients, which I will talk about later in this post.
Because I was not able to go into the clinic much, I am almost finished with my analysis! I have yet to compare the data that I have collected with national data, but I calculated the percent closure of 10 wounds from different patients from visit to visit and the percent closure over the course of about 3 months. I also calculated the average percent closure over 3 months from all 10 patients. Although I initially had no idea how to use Excel, with the guidance of Mr. Loudenslagel, I realized that you can plug in a formula into a certain "cell" and copy and paste it to adjacent cells. This greatly increased my efficiency. Instead of using a calculator to calculate the percent closure from visit to visit and recording each data point, I simply inserted the formula ((Y1-Y2)/Y1)*100)-- the percent change formula. I was then able to copy the relationship between Y1 and Y2, and paste it to another set of data points. However, I did encounter one obstacle : I have an extreme outlier in my pool of data. And, as we've learned in Statistics, this would cause my study to be statistically insignificant. When I return to the clinic next week, I hope to find another patient to use, but for now I've calculated the average percent closure over 3 months for all 10 patients with and without the outlier.
The most memorable patient I saw this week was certainly a decubitus ulcer. These are most commonly known as a pressure ulcer or a bed sore. Decubitus ulcers are caused by prolonged pressure on a certain area of the body that causes damage to the tissue. So far the pressure ulcers I've seen are on the ankle or foot somewhere, usually in diabetic patients. They are also usually not as severe as other types of wounds.
The patient I saw had an incredibly severe decubitus ulcer. It was located on his lower back, and, Dr. Weiland told me that it used to be so severe that you could see the entire pelvic bone in the wound. Although it had apparently improved since last visit, it was still extremely large.
Hopefully next week I can finally finish my analysis!
Friday, April 8, 2016
Week 9
Hello there, and welcome to Week 9 of my Senior Research Project!
Unfortunately, I didn't go in to the clinic much this week, because Dr. Weiland is out of town. Also, I missed my Thursday rotation because I am currently in Virginia visiting University of Virginia and William & Mary! I did go in to the clinic on Monday, and was able to see the progress of a few of Dr. Stein's patients.
However, because I did not go into clinic much this week, I had time to start working on my retrospective analysis of the wound care data. I began by typing 3 months worth of data from 10 patients into Excel. From the data, I found the length and width of the wound, and was therefore able to find the total area of the wound. Therefore, I can see the area from visit to visit over a span of 3 months. I initially wanted to find the percent closure of the wound area from week to week, but realized that this would not be possible because, since the wound clinic is out-patient, many of the patients do not come in every week. Instead, I will be able to find the percent closure between visits for every patient.
Although nothing very memorable happened this week, I obviously need to incorporate another gross picture, because at this point my blog just wouldn't be the same without one! This week's infection is called "necrotizing fasciitis." Like last week, I personally haven't seen this type of wound in the clinic because it is so severe. You may have heard of "flesh-eating bacteria" which gained prevalence in the news a couple of years ago, and that is exactly what necrotizing fasciitis is: a severe bacterial infection that actually kills the body's soft tissue. This is all thanks to a strain of bacteria called "group A Streptococcus." Although there are more types of bacteria that can cause necrotizing fasciitis, group A Streptococcus is the most common.
Unfortunately, I didn't go in to the clinic much this week, because Dr. Weiland is out of town. Also, I missed my Thursday rotation because I am currently in Virginia visiting University of Virginia and William & Mary! I did go in to the clinic on Monday, and was able to see the progress of a few of Dr. Stein's patients.
However, because I did not go into clinic much this week, I had time to start working on my retrospective analysis of the wound care data. I began by typing 3 months worth of data from 10 patients into Excel. From the data, I found the length and width of the wound, and was therefore able to find the total area of the wound. Therefore, I can see the area from visit to visit over a span of 3 months. I initially wanted to find the percent closure of the wound area from week to week, but realized that this would not be possible because, since the wound clinic is out-patient, many of the patients do not come in every week. Instead, I will be able to find the percent closure between visits for every patient.
Although nothing very memorable happened this week, I obviously need to incorporate another gross picture, because at this point my blog just wouldn't be the same without one! This week's infection is called "necrotizing fasciitis." Like last week, I personally haven't seen this type of wound in the clinic because it is so severe. You may have heard of "flesh-eating bacteria" which gained prevalence in the news a couple of years ago, and that is exactly what necrotizing fasciitis is: a severe bacterial infection that actually kills the body's soft tissue. This is all thanks to a strain of bacteria called "group A Streptococcus." Although there are more types of bacteria that can cause necrotizing fasciitis, group A Streptococcus is the most common.
This picture isn't the greatest, but I can assure you I was being kind. If you're brave enough, you can do a Google image search of necrotizing fasciitis to see just how bad it can be.
Next week I'll be back in the clinic and will finish my analysis of the data! Until then!
Friday, April 1, 2016
Week 8
Hello again!
This week was very interesting, because it was the first week I saw how a doctor's schedule can change very easily. Unlike other jobs, a doctor's schedule is dependent on the number of patients rather than having specific hours. Therefore, the number of hours a doctor works can be very different from day to day. During my rotation in the Wound Clinic, the hours are pretty regularly 8:30 to 12:30. However, this week I stayed in the clinic a lot longer: the last day, I stayed in until around 2. Although I realize that this is still not an incredibly long time, it showed me that doctors' schedules can be very irregular.
I collected all my data this week, and can finally start with my analysis! I am planning on calculating the percentage of closure in the wounds' areas over 90 days, along with calculating the rate of closure from visit to visit.
And, finally, I know what you've all been waiting for; after all, my blog wouldn't be complete without a couple of gross pictures, right? I learned about a few more different kinds of wounds this week. Because the Wound Clinic is mainly out-patient (patients are not currently admitted to the hospital for treatment), this type of wound is not commonly seen there because it is so severe. However, along with seeing the progression of many of the patients this week, the doctors taught me a bit about "gangrene."
Gangrene is defined as dead tissue caused either by lack of blood flow or infection. Lots of the patients have venous insufficiency or an infection in their wounds, which can cause the tissue surrounding the wound to die. The medical term for this dead tissue is "eschar" and must be removed for the wound to heal. Below is a picture of gangrene:
This week was very interesting, because it was the first week I saw how a doctor's schedule can change very easily. Unlike other jobs, a doctor's schedule is dependent on the number of patients rather than having specific hours. Therefore, the number of hours a doctor works can be very different from day to day. During my rotation in the Wound Clinic, the hours are pretty regularly 8:30 to 12:30. However, this week I stayed in the clinic a lot longer: the last day, I stayed in until around 2. Although I realize that this is still not an incredibly long time, it showed me that doctors' schedules can be very irregular.
I collected all my data this week, and can finally start with my analysis! I am planning on calculating the percentage of closure in the wounds' areas over 90 days, along with calculating the rate of closure from visit to visit.
And, finally, I know what you've all been waiting for; after all, my blog wouldn't be complete without a couple of gross pictures, right? I learned about a few more different kinds of wounds this week. Because the Wound Clinic is mainly out-patient (patients are not currently admitted to the hospital for treatment), this type of wound is not commonly seen there because it is so severe. However, along with seeing the progression of many of the patients this week, the doctors taught me a bit about "gangrene."
Gangrene is defined as dead tissue caused either by lack of blood flow or infection. Lots of the patients have venous insufficiency or an infection in their wounds, which can cause the tissue surrounding the wound to die. The medical term for this dead tissue is "eschar" and must be removed for the wound to heal. Below is a picture of gangrene:
As you can see above, some of the toes are dead or dying. These toes most definitely would have to be amputated. If you refuse to read my blog again I completely understand.
That's all for this week, folks!
Friday, March 25, 2016
Week 7
Hello again and welcome back to my blog! It was great being able to see my sister for a week, but I was certainly eager to get back into the wound clinic, and I certainly have more stories to tell!
Many of the patients who come in to the wound clinic either have diabetic foot ulcers that do not heal because of neuropathy and lack of blood flow or venous stasis ulcers, which basically is caused by slow blood flow. This week there were very few diabetic patients, and many venous stasis patients, which is quite different from the other weeks I've been there. Interestingly enough, one of the most common treatments many of these patients were using is a common household item. In fact, you probably have it right in your pantry. Apparently, honey is an extremely effective would management option, and it's pretty cheap. Patients can go to Sprout's and buy something called "Medihoney" for $20 as compared to super expensive drugs.
Many of the patients who come in to the wound clinic either have diabetic foot ulcers that do not heal because of neuropathy and lack of blood flow or venous stasis ulcers, which basically is caused by slow blood flow. This week there were very few diabetic patients, and many venous stasis patients, which is quite different from the other weeks I've been there. Interestingly enough, one of the most common treatments many of these patients were using is a common household item. In fact, you probably have it right in your pantry. Apparently, honey is an extremely effective would management option, and it's pretty cheap. Patients can go to Sprout's and buy something called "Medihoney" for $20 as compared to super expensive drugs.
According to the doctors at the wound clinic, Medihoney has some of the same properties as silver (no germs can grow in it).
One of the most memorable patients this week was an older woman who had been coming in throughout the past 7 weeks with a non-healing surgical wound on her ankle from a bypass surgery and an ulcer on her toe. Although the wound on her ankle seemed to be healing, when she came in last week, the wound was nearly closed; however, this week, the wound had completely opened up again and was incredibly infected. The doctors initially assumed it was a fungal infection, because it looked rather similar to this:
A culture of the wound showed that she had a staph infection, which is bacterial rather than fungal. What was really interesting is that I was able to see the bypass put in her leg. It was not working anymore, which explain the lack of healing in both of her wounds: there was very little blood flow in those areas.
I also began my retrospective analysis this week! Mr. Loudenslagel and I went through some of the patients charts looking for diabetic foot ulcers, and he cut off identifying information. Therefore, I was able to take these charts home with me. So far, we have seven patients with diabetic foot ulcers. I would prefer to have 10 because it would make some of my calculations easier, so we are hoping to find 3 more charts.
That's all for this week! Stay tuned for next week for more information on my analysis.
Friday, March 18, 2016
Friday, March 11, 2016
Week 5
Hello again and welcome to week 5 of my blog!
This week I continued doing my rounds. I hope to start my retrospective analysis when I get back in to clinic in 2 weeks. This week was interesting, however, because I'm finally able to see progress in the healing of people's wounds. Chronic wounds are rather slow to heal, so it takes a few weeks to be able to see them heal. While some patients' wounds progressed in a positive way, others were not so lucky.
Many of the patients were discharged this week because they kept their feet elevated and wore their compression socks. The patient who had the old pace maker, which I talked about in another one of my blogs, has improved a lot. Although his wound still has a rather large tunnel leading towards his belly button, the opening is smaller and he was able to get his stitches taken out this week. Some of the other patients who had skin substitutes have also improved. One patient came in with a rather large ulcer on her leg, and Dr. Stein put dermapure, a donated skin collagen, to cover the wound:
She came back in to clinic this week and her wound was close to being completely closed! Some patients, however was not as lucky. Another patient had a wound near his ankle, and the doctor put dermapure on his wound. However, dermapure does not always take: the skin substitute did not properly integrate into the wound and became incredibly infected.
I also become rather familiar with the different drugs related to wound care. The doctors frequently prescribe genomycin, bactroban, lydocaine, iodosorbe, sylvadine, etc. However, the most frequent prescription continues to be elevation and compression.
Lots of the patients have actually know my name now, and it's great to walk into their rooms and be able to connect with the patient, which is one of the best parts about being a doctor, in my opinion.
I won't have a post next week, because I will be taking my spring break then, but stay tuned in 2 weeks for my next post!
This week I continued doing my rounds. I hope to start my retrospective analysis when I get back in to clinic in 2 weeks. This week was interesting, however, because I'm finally able to see progress in the healing of people's wounds. Chronic wounds are rather slow to heal, so it takes a few weeks to be able to see them heal. While some patients' wounds progressed in a positive way, others were not so lucky.
Many of the patients were discharged this week because they kept their feet elevated and wore their compression socks. The patient who had the old pace maker, which I talked about in another one of my blogs, has improved a lot. Although his wound still has a rather large tunnel leading towards his belly button, the opening is smaller and he was able to get his stitches taken out this week. Some of the other patients who had skin substitutes have also improved. One patient came in with a rather large ulcer on her leg, and Dr. Stein put dermapure, a donated skin collagen, to cover the wound:
I also become rather familiar with the different drugs related to wound care. The doctors frequently prescribe genomycin, bactroban, lydocaine, iodosorbe, sylvadine, etc. However, the most frequent prescription continues to be elevation and compression.
Lots of the patients have actually know my name now, and it's great to walk into their rooms and be able to connect with the patient, which is one of the best parts about being a doctor, in my opinion.
I won't have a post next week, because I will be taking my spring break then, but stay tuned in 2 weeks for my next post!
Friday, March 4, 2016
Week 4
Hello again and welcome to my report of another excited week at Osborn Wound Clinic!
Many of the patients the doctors see mainly have the same problems: ulcers caused by diabetes, poor vein circulation causing wounds, or simply trauma-induced ulcers. However, this week I learned that this is not always the case. The picture below shows what is known generally as "varicose veins."
As we learned in biology, veins carry blood back to the heart. However, they generally have to work against gravity (ex. from the feet to the heart) to get the blood back. Therefore, veins have valves that open and close when the heart pumps blood. Varicose veins are a result of widening valves that no longer touch, which allows the blood to flow back through the valves and downwards, increasing pressure from the veins. The pressure from the blood can actually cause a pressure ulcer, which can actually create an ulcer.
I also saw a lot of wounds resulting from surgery this week. A couple of patients recently underwent spinal surgery. The surgical site on these patients, however, did not heal correctly. On both of these patients, there was a rather large tunnel going from the outside of the body back into the spinal column. The doctors were actually able to take a cotton swab and stick it pretty far inside the patients' bodies. The reason these people don't heal correctly can be from a multitude of reasons: diabetes, old age, etc.
Finally, I leaned that hyperbaric oxygen therapy does more than treat wounds. As mentioned in a previous post, hyperbaric oxygen therapy increases the pressure of normal air to aid in the healing of wounds by allowing more oxygen to flow to wound sites. However, this is not all it does: I found a list of all the ailments hyperbaric oxygen can aid in ranging from AIDS to brain damage. This week, a patient came in with some brain damage relating to a scuba diving accident, and the doctor prescribed hyperbaric oxygen therapy to see if the brain damage can be healed. It will be interesting to see his progress in the next couple of weeks.
Next week, I will be starting my data analysis of the clinic, along with doing rounds with the doctors. Until then!
Many of the patients the doctors see mainly have the same problems: ulcers caused by diabetes, poor vein circulation causing wounds, or simply trauma-induced ulcers. However, this week I learned that this is not always the case. The picture below shows what is known generally as "varicose veins."
As we learned in biology, veins carry blood back to the heart. However, they generally have to work against gravity (ex. from the feet to the heart) to get the blood back. Therefore, veins have valves that open and close when the heart pumps blood. Varicose veins are a result of widening valves that no longer touch, which allows the blood to flow back through the valves and downwards, increasing pressure from the veins. The pressure from the blood can actually cause a pressure ulcer, which can actually create an ulcer.
I also saw a lot of wounds resulting from surgery this week. A couple of patients recently underwent spinal surgery. The surgical site on these patients, however, did not heal correctly. On both of these patients, there was a rather large tunnel going from the outside of the body back into the spinal column. The doctors were actually able to take a cotton swab and stick it pretty far inside the patients' bodies. The reason these people don't heal correctly can be from a multitude of reasons: diabetes, old age, etc.
Finally, I leaned that hyperbaric oxygen therapy does more than treat wounds. As mentioned in a previous post, hyperbaric oxygen therapy increases the pressure of normal air to aid in the healing of wounds by allowing more oxygen to flow to wound sites. However, this is not all it does: I found a list of all the ailments hyperbaric oxygen can aid in ranging from AIDS to brain damage. This week, a patient came in with some brain damage relating to a scuba diving accident, and the doctor prescribed hyperbaric oxygen therapy to see if the brain damage can be healed. It will be interesting to see his progress in the next couple of weeks.
Next week, I will be starting my data analysis of the clinic, along with doing rounds with the doctors. Until then!
Friday, February 26, 2016
Week 3
Hello again!
This week I had four half days with Dr. Stein and Dr. Weiland, as opposed to only two last week. This means I saw twice the patients, and, therefore, twice the wounds.
Like I mentioned last week, most of the patients are either very old and/or diabetic. When I say old, I mean really old. For example, this past week, over 75% of the patients were 85 years old or older. Age plays a role in the rate wounds heal: the older you get, the more likely you'll have to go see the nice people at Osborn Wound Clinic.
Most of the patients with more severe wounds have to come in weekly to see how they're healing. Since I came in last Wednesday and Thursday, I was able to see how some of the same patients were progressing with their wounds. Some of the wounds drastically improved: a patient came in 2/last week with a wound resulting from running his leg into a table (trauma). I saw him again on Thursday (2/25), and his wound looked a lot better. Some of the other wounds I saw, however, looked exactly the same. The patients whose wounds looked worse resulted from them not following the doctors' orders (keeping their leg elevated, wearing a compression sock to reduce swelling, etc), and I learned that possibly the most important thing to do in order to heal is to listen to what your doctor tells you.
Many of the wounds I saw involved hematomas, pictured below:
This week I had four half days with Dr. Stein and Dr. Weiland, as opposed to only two last week. This means I saw twice the patients, and, therefore, twice the wounds.
Like I mentioned last week, most of the patients are either very old and/or diabetic. When I say old, I mean really old. For example, this past week, over 75% of the patients were 85 years old or older. Age plays a role in the rate wounds heal: the older you get, the more likely you'll have to go see the nice people at Osborn Wound Clinic.
Most of the patients with more severe wounds have to come in weekly to see how they're healing. Since I came in last Wednesday and Thursday, I was able to see how some of the same patients were progressing with their wounds. Some of the wounds drastically improved: a patient came in 2/last week with a wound resulting from running his leg into a table (trauma). I saw him again on Thursday (2/25), and his wound looked a lot better. Some of the other wounds I saw, however, looked exactly the same. The patients whose wounds looked worse resulted from them not following the doctors' orders (keeping their leg elevated, wearing a compression sock to reduce swelling, etc), and I learned that possibly the most important thing to do in order to heal is to listen to what your doctor tells you.
Many of the wounds I saw involved hematomas, pictured below:
A hematoma is defined as a localized collection of blood outside of the blood vessels (basically a big bruise). The elderly can easily get a hematoma because of the thinness of their skin, but a patient who is taking blood thinners can also quickly get a hematoma because of the rate they bleed.
Many of the patients are interesting as well. Before I started my rotation, I assumed most patients followed the doctor's orders. However, I quickly learned this week that this is not the case. If a doctor prescribed elevation or a compression sock, many of the patients were non-compliant, which surprised me. And this is why, in many cases, the wounds did not heal.
Finally, one of the most interesting things I saw this week was a picc line being removed. A picc line is basically a long lasting IV which is inserted in the arm and goes through a small vein towards the large arteries near the heart. You can run medication through these for fast-acting results, and its good for patients who need a lot of medication because you can leave it in for a couple weeks.
That's all for this week, folks! Stay tuned for next week for more wound updates!
Saturday, February 20, 2016
Week 2
Welcome back to my weekly blog! This week, I ironed out the specifics of my project and actually started my rotations with the doctors at the clinic.
I first met with the director of the Wound Clinic, Mark Loudenslagel, to figure out exactly what I'd be doing at the clinic since my pervious plans fell through. Last week, I discussed that I would be doing a retrospective study using the data collected by the Wound Clinic compared to national data. I would then be able to determine the effectiveness of the Wound Clinic at Osborn. We still haven't yet heard back from the legal department at the hospital to see if I would be able to have access to the data, but we have thought of a way around that; the personal information associated with the data can be expunged so that all I will have is raw data to work with (which wouldn't be a problem with the legal department).
I also found an area I would like to focus my project on. Osborn Wound Clinic has a huge hyperbaric chamber. The hyperbaric chamber delivers oxygen at a high pressure which aids in wound healing because it delivers a high amount of oxygen to the wound site.
Over the next 7 weeks I will be able to follow a diabetic patient using the hyperbaric chamber. I'll have access to pictures of his or her wound each week to see how effective the hyperbaric chamber is.
Finally, I started my rounds with Dr. Stein and Dr. Weiland this week. I started last Wednesday (2/17) with Dr. Weiland and also went in last Thursday (2/18) with Dr. Stein. Before going into this project, I assumed most of the wounds were simply a result of trauma. However, I soon realized this was not true at all: almost all the patients I have seen so far have diabetes. A patient with diabetes has poor circulation to his or her extremities and has no sensation on their feet. As a result, their wounds have a difficult time healing on their own due to the low amount of oxygen and, if they step on a sharp object, he or she will have no idea because of the lack of sensation. This can lead to a Diabetic Foot Ulcer, as pictured below.
I first met with the director of the Wound Clinic, Mark Loudenslagel, to figure out exactly what I'd be doing at the clinic since my pervious plans fell through. Last week, I discussed that I would be doing a retrospective study using the data collected by the Wound Clinic compared to national data. I would then be able to determine the effectiveness of the Wound Clinic at Osborn. We still haven't yet heard back from the legal department at the hospital to see if I would be able to have access to the data, but we have thought of a way around that; the personal information associated with the data can be expunged so that all I will have is raw data to work with (which wouldn't be a problem with the legal department).
I also found an area I would like to focus my project on. Osborn Wound Clinic has a huge hyperbaric chamber. The hyperbaric chamber delivers oxygen at a high pressure which aids in wound healing because it delivers a high amount of oxygen to the wound site.
Finally, I started my rounds with Dr. Stein and Dr. Weiland this week. I started last Wednesday (2/17) with Dr. Weiland and also went in last Thursday (2/18) with Dr. Stein. Before going into this project, I assumed most of the wounds were simply a result of trauma. However, I soon realized this was not true at all: almost all the patients I have seen so far have diabetes. A patient with diabetes has poor circulation to his or her extremities and has no sensation on their feet. As a result, their wounds have a difficult time healing on their own due to the low amount of oxygen and, if they step on a sharp object, he or she will have no idea because of the lack of sensation. This can lead to a Diabetic Foot Ulcer, as pictured below.
Ulcers are not specific to feet, however. A diabetic patient can also easily develop an ulcer on the lower part of their leg; I saw quite a few of those as well. I observed some debridement of wounds as well. Debridement is the removing of dead tissue from wounds to aid in healing.
This week, I learned a lot about wound care, but I also learned more about myself: I have a pretty strong stomach.
Friday, February 12, 2016
Week 1
This week, I officially started my SRP! Well, almost. I go into the clinic to observe patients and physicians next week, which I am extremely excited for, but this week was mainly dedicated to changing my plans for my SRP.
In my last post, I mentioned that I would be writing up a protocol to submit to the IRB for a study comparing Dermapure and EndoForm as agents in wound healing. However, after a closer look at an "Expedited Research Application" template, I soon discovered that I was out of my depth. I had never seen an Expedited Research Application before, and was confused on how to proceed. The template was thirteen pages long, requiring answers to specific questions that I did not know. I, therefore, scheduled a meeting with my mentor at Osborn Hospital and brought the template along to go over some of the questions I had. Dr. Stein talked through the template with me and I was confident I would be able to write up a successful protocol. At closer inspection, however, I saw that the principal investigators must have "Human Subject Training" in order to conduct a study. I asked Dr. Stein about this, and he told me that neither him or Dr. Weiland had completed this. I, therefore, contacted the director of the Wound Clinic asking whether this would be an obstacle in allowing us to submit the application. We eventually came to the conclusion that going through the IRB would not be possible because of the lack of Human Subject Training and the limited time constraints of the SRP-- it would take about a week for the application to go through the IRB and I would, therefore, not be able to finish my SRP.
In case this were to happen, however, I had a back up plan. After my initial meeting with Dr. Stein and Dr. Weiland, I spoke to the director of the Wound Clinic, Mark Loudenslagel, about a potential retrospective study using the data the clinic had collected in the past. Mr. Loudenslagel also has access to national data regarding wound care, and I would be able to compare the Osborn Wound Clinic's stats to national data. This is my current plan at the moment. However, we are still waiting to hear from legal services and Human Resources if I am allowed to have access to this data. I should know by Monday at the latest.
This week I've also been completing volunteer requirements: I have so far gotten one tuberculosis (TB) test (which I passed, thankfully), a flu shot, attended volunteer orientation, and am waiting to get my second TB test on Monday (2/15). I still have to complete some training online, but once that's complete I'll have a hospital badge and will be able to start my SRP.
Next week, I will be going into the clinic for an official tour and will solidify a specific area of wound healing that I will be focused on. During my meeting with my mentors, I briefly saw a hyperbaric oxygen chamber that aids in wound healing, and I am hopeful to focus on that. Make sure to read my blog next week to see what exactly I'll be focusing on!
In my last post, I mentioned that I would be writing up a protocol to submit to the IRB for a study comparing Dermapure and EndoForm as agents in wound healing. However, after a closer look at an "Expedited Research Application" template, I soon discovered that I was out of my depth. I had never seen an Expedited Research Application before, and was confused on how to proceed. The template was thirteen pages long, requiring answers to specific questions that I did not know. I, therefore, scheduled a meeting with my mentor at Osborn Hospital and brought the template along to go over some of the questions I had. Dr. Stein talked through the template with me and I was confident I would be able to write up a successful protocol. At closer inspection, however, I saw that the principal investigators must have "Human Subject Training" in order to conduct a study. I asked Dr. Stein about this, and he told me that neither him or Dr. Weiland had completed this. I, therefore, contacted the director of the Wound Clinic asking whether this would be an obstacle in allowing us to submit the application. We eventually came to the conclusion that going through the IRB would not be possible because of the lack of Human Subject Training and the limited time constraints of the SRP-- it would take about a week for the application to go through the IRB and I would, therefore, not be able to finish my SRP.
In case this were to happen, however, I had a back up plan. After my initial meeting with Dr. Stein and Dr. Weiland, I spoke to the director of the Wound Clinic, Mark Loudenslagel, about a potential retrospective study using the data the clinic had collected in the past. Mr. Loudenslagel also has access to national data regarding wound care, and I would be able to compare the Osborn Wound Clinic's stats to national data. This is my current plan at the moment. However, we are still waiting to hear from legal services and Human Resources if I am allowed to have access to this data. I should know by Monday at the latest.
This week I've also been completing volunteer requirements: I have so far gotten one tuberculosis (TB) test (which I passed, thankfully), a flu shot, attended volunteer orientation, and am waiting to get my second TB test on Monday (2/15). I still have to complete some training online, but once that's complete I'll have a hospital badge and will be able to start my SRP.
Next week, I will be going into the clinic for an official tour and will solidify a specific area of wound healing that I will be focused on. During my meeting with my mentors, I briefly saw a hyperbaric oxygen chamber that aids in wound healing, and I am hopeful to focus on that. Make sure to read my blog next week to see what exactly I'll be focusing on!
Saturday, January 23, 2016
Introduction
Hello everyone!
My name is Alison Burge and I am a senior at BASIS Scottsdale High School. BASIS isn't like most high schools; it allows its seniors to conduct a Senior Research Project (SRP) rather than attend regular classes during the third trimester of school. For 10 weeks (from February until April) I will be working at the Wound Clinic at Osborn Hospital. I hope to record my observations from my project on this blog!
My father is currently an infectious diseases physician, so medicine was a part of life growing up. From a young age, my father would tell me stories about the patients he had and the methods he used to treat them. Medicine seemed to me like putting pieces together in a puzzle or solving a riddle, and, because of my naturally curious nature, this immediately got me interested in a healthcare profession myself. Although my intended career path has changed from veterinarian to orthodontist to medical doctor, healthcare has always been the intended goal. I am hoping that this SRP will help me solidify my intended career path while learning more about wounds.
I will be working with both Dr. Stein and Dr. Weiland for the duration of my research project. At my request, my father spoke to some of his colleagues about me possibly working with them for ten weeks, and I am very grateful that they offered to help me!
I met with Dr. Stein and Dr. Wayland about a week ago to discuss what I would be doing during this project and when we would start. While during the meeting we were unsure whether I would be able to conduct a study using the data the doctors collect, which would have to be approved by the Institutional Review Board (IRB), Dr. Stein recently spoke to IRB to see how long it would take for a proposal to be approved, and it turns out it will only take approximately 7-10 days. This means I can use their data to conduct a study after all! I have yet to write the proposal, but I hope to start doing this in the next week. Although the actual plan for my SRP is still tentative, I am hoping to follow patients at the Wound Clinic and determine background rates of healing for two different wound care products. This could be, for example, using different skin replacement and analyzing if they differ in performance for healing wounds. I hope to gather patients for 4 or 5 weeks and analyze the different wound care products for the next 4 or 5 weeks, while leaving a week or two at the end to crunch data using statistics.
The next step in my process is to write the IRB proposal and send it in for review so that I can start my project during the week of February 8th. I will be going in to the Wound Clinic for 15 hours each week and I am extremely eager to start! Please join me during my exploration of the fascinating world of wound care!
My name is Alison Burge and I am a senior at BASIS Scottsdale High School. BASIS isn't like most high schools; it allows its seniors to conduct a Senior Research Project (SRP) rather than attend regular classes during the third trimester of school. For 10 weeks (from February until April) I will be working at the Wound Clinic at Osborn Hospital. I hope to record my observations from my project on this blog!
My father is currently an infectious diseases physician, so medicine was a part of life growing up. From a young age, my father would tell me stories about the patients he had and the methods he used to treat them. Medicine seemed to me like putting pieces together in a puzzle or solving a riddle, and, because of my naturally curious nature, this immediately got me interested in a healthcare profession myself. Although my intended career path has changed from veterinarian to orthodontist to medical doctor, healthcare has always been the intended goal. I am hoping that this SRP will help me solidify my intended career path while learning more about wounds.
I will be working with both Dr. Stein and Dr. Weiland for the duration of my research project. At my request, my father spoke to some of his colleagues about me possibly working with them for ten weeks, and I am very grateful that they offered to help me!
I met with Dr. Stein and Dr. Wayland about a week ago to discuss what I would be doing during this project and when we would start. While during the meeting we were unsure whether I would be able to conduct a study using the data the doctors collect, which would have to be approved by the Institutional Review Board (IRB), Dr. Stein recently spoke to IRB to see how long it would take for a proposal to be approved, and it turns out it will only take approximately 7-10 days. This means I can use their data to conduct a study after all! I have yet to write the proposal, but I hope to start doing this in the next week. Although the actual plan for my SRP is still tentative, I am hoping to follow patients at the Wound Clinic and determine background rates of healing for two different wound care products. This could be, for example, using different skin replacement and analyzing if they differ in performance for healing wounds. I hope to gather patients for 4 or 5 weeks and analyze the different wound care products for the next 4 or 5 weeks, while leaving a week or two at the end to crunch data using statistics.
The next step in my process is to write the IRB proposal and send it in for review so that I can start my project during the week of February 8th. I will be going in to the Wound Clinic for 15 hours each week and I am extremely eager to start! Please join me during my exploration of the fascinating world of wound care!
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