This paper is only available as a PDF. To read, Please Download here.
Background. A multidisciplinary wound care clinic was established to diagnose and treat patients with nonhealing ulcers of the lower extremity.
Methods. The clinic was organized under the direction of the departments of vascular surgery and dermatology with support by the departments of plastic surgery, hyperbaric medicine, orthopedic surgery, and podiatry, and a research nurse.
Results. In the first 4 years and 3 months, 683 patients were evaluated. One hundred seventy-one patients underwent outpatient testing in the noninvasive vascular laboratory and 30 patients underwent angiography. Causes of the ulcers were venous stasis, 280 patients (41%); diabetic neuropathy, 182 patients (27%); arterial insufficiency, 119 patients (17%); rheumatologic disorders, 38 patients (6%); trauma, 15 patients (2%); and in 49 patients (7%) a variety of other disorders. One hundred seventy-nine operations were performed including 86 operating room débridements, 48 amputations (43 toe, 4 below knee, 1 above knee), 23 arterial bypasses, 1 venous bypass, 14 skin grafts, 2 pedicle flaps, and 5 excisions of tumor. Fifty-six patients with cellulitis were admitted to the hospital for intravenous antibiotics and 12 patients were treated with hyperbaric oxygen therapy. One-hundred thirty-two patients were entered into randomized prospective trials of topical growth factors on Institutional Review Board approved protocols.
Conclusions. We concluded that a multidisciplinary approach to wound care is beneficial to patients with chronic wounds and provides a mechanism for clinical investigation on the healing of problem wounds.
To read this article in full you will need to make a payment
Purchase one-time access:Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
One-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:Subscribe to Surgery
Already a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
- The presentation and management of chronic venous insufficiency.Pract Cardiol. 1980; 6: 197-202
- Leg ulcers.J Am Acad Dermatol. 1991; 25: 965-987
- The diabetic foot: pathophysiology and treatment.Clin Endocrinol Metab. 1986; 15: 889-916
- Lower extremity amputations in people with diabetes: epidemiology and prevention.Diabetes Care. 1989; 12: 24-31
- The diabetic foot.CV Mosby, St. Louis1988
- Leg ulcers, epidemiology and aetiology.Br J Surg. 1986; 73: 693-696
- Randomized prospective double-blind trial in healing chronic diabetic foot ulcers.Diabetes Care. 1992; 15: 1598-1604
- The diabetic foot: impact of a foot clinic.Q J Med. 1986; 232: 763-771
- The importance of randomized prospective trials in evaluating therapy for wound healing.Wounds. 1991; 3: 111-115
- Clinical trials with purified platelet releasate Clinical and experimental approaches to dermal and epidermal repair: normal and chronic wounds.in: Wiley-Liss Inc, New York1991: 103-113
☆Presented at the Fiftieth Annual Meeting of the Central Surgical Association, Cincinnati, Ohio, March 4–6, 1993.
© 1993 Published by Elsevier Inc.