Wound Care and Limb Salvage - St. Luke`s Roosevelt Hospital
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Transcript Wound Care and Limb Salvage - St. Luke`s Roosevelt Hospital
Wound Care and Limb Salvage
St. Luke’s – Roosevelt Hospital
Center
Goals
Retain limbs
Minimally invasive and invasive therapy
Aggressive treatment of wounds
Wound care team algorithms
Clinical trial access
Cutting edge therapeutic interventions
Aggressive rehabilitation services
How we achieve these goals?
Aggressive attempts at limb salvage
Using a combination of techniques
When a wound is inevitable
Inpatient wound care team
Outpatient wound care team
Standardized formulary
Individualized plan for each patient
Invasive surgical options
Minimally invasive techniques
Outcomes of Aggressive
intervention
5 year 1° patency –
65 to 70 %
5 year 2° patency –
80 to 85 %
5 year limb salvage –
85 to 90%
Wound care team
Speeds time to recovery
Integrates different experience
Integrates different perspectives
Provides increased continuity
Decreases contradictory treatment
application
Wound care team
Allows for better development and
application of algorithms
Aids in patient and caregiver education
Provides for equal voice from various
care backgrounds
Much easier to implement preventive
strategies
Application of the Team Concept/
Standardized Formulary
Further sub-specialization
Diabetic foot team
Amputation team
Decubitus team
• Stoma team
Standardized Formulary
Allows for less caregiver and patient
confusion
Decreases cost
Decreases lapses in therapy once initiated
Improves time to recovery ?
Specific team requirements
Diabetic foot
Diabetologist- Inpatient and Outpatient
Nurse specialist - VNS liason
Nutritionist
Physical therapist - Outpatient liason
Podiatrist
Prosthetist
Social worker
Vascular surgeon (Team leader)
Specific team requirements
Amputation Team
Nurse specialist - VNS liason
Nutritionist
Physical therapist - Outpatient liason
Podiatrist
Prosthetist
Vascular / Orthopedic surgeon
Social worker
Psychologist
Novel approaches and clinical
trials
Growth factor studies
Vacuum Assisted Closure Device studies
Drug eluting stent trials
At present seven active clinical trials
focused at these problems
Multidisciplinary plan of care