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.

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.

Week 6

Spring break

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!

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!