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Abstract
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.
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Article info
Footnotes
☆Presented at the Fiftieth Annual Meeting of the Central Surgical Association, Cincinnati, Ohio, March 4–6, 1993.
Identification
Copyright
© 1993 Published by Elsevier Inc.
