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May 2008 Issue

John Kitzmiller, MD, chief of plastic, reconstructive and hand surgery at UC.
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Plastic Surgery Teams Up With Drake Center to Tackle Difficult Chronic Wound Cases

By Amanda Harper
Published May 2008

For some patients, a wound isn’t a temporary inconvenience—it is a painful, daily frustration that can become limb- or life-threatening if left untreated.

John Kitzmiller, MD, chief of plastic, reconstructive and hand surgery at UC, has partnered with physicians and nurses at Drake Center’s Advanced Wound Care Program to tackle tough cases and improve the lives of patients with chronic wounds.

For Helen Colley, treatment at the Advanced Wound Care Program was a major turning point in her life.

Colley, 73, suffers from cutaneous scleroderma, an autoimmune disease that compromises the skin’s blood supply. For someone with this condition, a small abrasion can quickly advance into an open, oozing wound susceptible to infection. 

After suffering from leg ulcers and undergoing several skin graft surgeries, Colley says she was “discouraged and at a very low point” by the time she had her third ulcer graft in May 2007 with Kitzmiller.

“Before surgery, my ulcer looked bigger every time I changed the dressing,” she says. “I had to keep my leg elevated all the time—even in the bathtub, which made me homebound. I hadn’t seen improvement for so long I just wanted to cry.”

Kitzmiller referred Colley to the Drake Advanced Wound Care Program for specialized follow-up care in the inpatient hyperbaric medicine facility immediately following surgery. In her eight-week stay at Drake, she had 60 hyperbaric oxygen treatments and intravenous anti-biotic therapy.

“We wanted to make sure we ad-dressed the bacteria that was preventing Ms. Colley’s wound from healing fully, and the wound care team was best equipped to give that specialized care,” says Kitzmiller.

Today, Colley is symptom free but makes periodic trips to the Advanced Wound Care Program for follow-up. She is able to spend more time out of the house and walking her two German Shepherds.

“The entire time I was in treatment, the Drake Center staff was supportive and positive,” recalls Colley. “They told me I would get better, and they were true to their word!”

The Drake Center wound healing team includes 13 specially trained wound care nurses, a full-time medical director and clinical nurse specialist dedicated entirely to implementing advanced care for patients with complex wounds like Colley’s.

The team handles both in- and outpatient care for more than 110 patients per month with chronic wounds. Bryan Adkins, MD, serves as medical director.

Founded in 2004, the wound care program at Drake Center was originally a collaboration between Drake Center and the UC surgery department—specifically the plastic and burn surgeons. The inpatient clinic began operation in February 2005 and expanded in 2006 to include outpatient care.

“Our program is unique because it offers an integrated system of both inpatient and outpatient care,” says Lu Ann Reed, clinical manager for the Advanced Wound Care Program.

The partnership between the UC surgeons and Drake’s wound care team is ideal, she says, because it allows them both to do what they do best.

“Wound treatment has to be tailored to the patient because every case has different complicating factors,” explains Reed. “Our specialists are very familiar with the latest products and methods used to help complex wounds heal, so we can offer specific treatment strategies and insight for healing once the surgeon has completed his work.”

In addition to hyperbaric oxygen treatments—where the patient breathes 100 percent oxygen at higher-than-normal pressure to reoxygenate the blood and tissues—the team often uses bioengineered skin substitutes, negative-pressure wound therapy, transcutaneous oxygen monitoring and other methods to encourage wound healing.

Mary Arnold Long, clinical nurse specialist for the program, says treating non-healing wounds like Colley’s is a complicated process because many patients have complicating factors such as diabetes, high blood pressure or compromised immune systems that prevent proper healing.

“In addition to medical applications to promote healing, we also focus on teaching lifestyle changes that will help the patient heal and improve his or her overall quality of life,” adds Long.

The program was recently named a finalist in the 2008 Cincinnati Business Courier Health Care Heroes awards ceremony in the provider category.

Reed was also recognized in September 2007 by the National Alliance of Wound Care as its first Outstanding Wound Care Nurse of the year.

For more information on this partnership or to refer a patient, call (513) 418-2707.

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