MicroDoc Portable Negative Pressure Wound Therapy Units in Final Stages of FDA Approval
The Wound Vac Company seeking surgeons to evaluate new wound care system from Pensar Medical
Fernandina Beach, FL – September 10, 2020 — The Wound Vac Company is pleased to announce that the new MicroDoc – a unique, single-patient-use disposable negative pressure wound therapy system that provides portability and discretion for active patients – is now in the final stages of FDA approval. The units, which are made in the U.S. by Pensar Medical, should be universally available in early 2021.
Compared with larger, traditional negative pressure units, these smaller systems are lightweight, ultra-quiet and small enough to fit into a pocket or purse. Powerful yet simple to operate, the MicroDoc supports uninterrupted negative pressure wound therapy for patients during normal, everyday activities.
The Wound Vac Company CEO and founder Scott Bergquist said, "As the Master Distributor for Pensar Medical, we are very excited about introducing their MicroDoc as the first single-patient use negative pressure wound therapy unit with three pressure settings – 50, 80 and 125 mmHg – to treat a wider range of needs and to help patients heal as quickly as possible.”
The MicroDoc units also feature state-of-the-art Enluxtra Adaptive Dressings, which maintain a moist environment necessary for healing wounds while providing superior absorption. As an added benefit, these dressings can help reduce scarring.
“With FDA trials complete, we are actively reaching out to dermatologists, plastic and general surgeons who are interested in partnering with us for patient applications,” said Bergquist. “In case studies thus far, we have found the unit to eliminate the need for constant dressing changes and to bridge the gap between a traditional negative pressure unit and the final phase of wound healing.”
For additional information about the MicroDoc or to inquire about a patient case study, please contact The Wound Vac Company at info@thewoundvaccompany.com or visit thewoundvaccompany.com/portable-microdoc-wound-vac.
Reexamining the Literature on Skin Injuries in End-Of-Life Patients
This article from Advances in Skin & Wound Care synthesizes the literature regarding the concepts of “terminal” skin injuries and wounds – such as pressure injuries & ulcers – found in end-of-life patients.
This article from Advances in Skin & Wound Care synthesizes the literature regarding the concepts of “terminal” skin injuries and wounds found in patients at the end of life. These wounds include terminal ulcers, terminal tissue injuries and skin failure. Also included is a discussion of avoidable and unavoidable pressure injuries and ulcers.
How to wrap a short-stretch compression bandage
This video from Advances in Skin & Wound Care shows how to wrap a short-stretch compression bandage for a patient without wounds or skin breakdown.
What happens after a patient is discharged to home? This video from Advances in Skin & Wound Care shows how to wrap a short-stretch compression bandage for a patient without wounds or skin breakdown.
https://journals.lww.com/aswcjournal/Pages/videogallery.aspx?videoId=7&autoPlay=true
Negative Pressure Wound Therapy for Closed Surgical Incisions
This is a case study in which negative pressure wound therapy was used on clean, closed surgical wounds. Learn more about the outcomes & implications of the use of NPWT for post-surgical patients.
This report from Wound Management and Prevention outlines a case study in which negative pressure wound therapy was used on clean, closed surgical wounds in four high-risk patients (two men, two women). All wounds healed well. Learn more about the study, outcomes and implications of the use of NPWT for post-surgical patients.
https://www.o-wm.com/content/use-negative-pressure-therapy-closed-surgical-incisions-a-case-series
How dietary protein aids in wound healing
This article discusses the role of protein & amino acids in wound healing and offers suggestions on ways to ensure patients are getting the nutrition they need for proper wound healing.
This article from Wound Care Advisor discusses the role of nutrition – specifically, protein and amino acids – in healing wounds. Adequate protein is crucial for proper recovery, and the article offers a number of suggestions on ways to increase protein intake and work with patients to ensure that they are getting the nutrition they need for proper wound healing.
https://woundcareadvisor.com/how-dietary-protein-intake-promotes-wound-healing-vol2-no6/
Debridement Options and Wound Treatment
This article reviews the most common options for debridement of wounds, including sharp, surgical, autolytic, mechanical and biosurgical debridement methods.
This article from WoundSource reviews the most common options for debridement of wounds, including sharp debridement, surgical debridement, autolytic debridement, mechanical debridement and biosurgical debridement methods. The article provides an overview of each type, along with considerations for medical staff, and notes the importance of providing patients with sufficient information to select the best option.
https://www.woundsource.com/blog/debridement-options-considerations-in-selecting-debridement-methods
An Introduction to Burn Care (from Advances in Skin & Wound Care)
This article provides an overview of burn wounds and care, including types of burns, size and depth, potential complications, guidelines for referral, treatment and long-term results.
This article, published by Advances in Skin & Wound Care, provides an overview about burns and current burn care, including types of burns, burn size and depth, potential complications, guidelines for referral, treatment of burn wounds and information about long-term results.
Chronic Wounds and Negative Pressure Wound Therapy
This article from NCBI reviews current practices in the management of chronic wounds, including the role of negative pressure therapy in wound care.
This article from The National Center for Biotechnology Information (NCBI) reviews current practices in the management of chronic wounds, including costs and barriers to healing, as well as the role of negative pressure therapy in wound care.
Standardizing Wound Care Dressings For Cost Savings & Better Results
Learn how a Texas wound care clinic achieved significant savings and improved outcomes and patient & clinician satisfaction by standardizing wound dressings.
This article by Randall Wolcott, MD, and Vicki Fischenich, RN, MSN, GNP-BC, WCC, outlines how a Texas wound care clinic achieved significant cost savings while improving outcomes, staff productivity, and patient and clinician satisfaction by adopting a new method of standardization.
We would like to thank Vicki Fischenich, RN, for allowing us to share this article.
http://www.todayswoundclinic.com/files/TWC_April2014_Wolcott.pdf
About the Negative Pressure Wound Therapy (NPWT) Process
In this post, we look at the types of wounds negative pressure wound therapy (NPWT) is used for and briefly describe how the process works.
Negative pressure wound therapy (NPWT) is a medical procedure that uses a vacuum, tubing and dressing to treat a wide variety of burns, acute, chronic and complex wounds. The vacuum, or “wound vac” control unit, is connected to the wound via tubing and a clean dressing that pulls fluid away from the open wound and protects the area from infection.
In this post, we’ll look at the types of wounds NPWT is used for and briefly describe the process.
Uses for NPWT
As described in our recent post on wounds and wound healing, NPWT can be used to help treat and heal:
Diabetic ulcers
Bedsores (also known as pressure ulcers)
First- and second-degree burns
Trauma and gunshot wounds
Surgical wounds, especially those with a high risk of infection
Other complex wounds with large amounts of drainage
Negative pressure therapy is often used in hospitals and clinics but can also be used in homes by visiting home health care providers.
The NPWT process has become increasingly popular over the past 20 years, in part because it is non-invasive, can be administered in many settings and provides just the right amount of moisture necessary for healing while also protecting wounds from outside contaminants, such as dirt and bacteria.
The Process
After cleaning (a process also known as debridement), a sterile, open-cell foam or gauze is cut to fit the size of the wound and packed into the opening. Next, the wound is covered with a clear, thin dressing that creates an airtight seal around the wound.
A vacuum pump, or control unit, is attached to the dressing with tubing, which pulls fluid and dead tissue away from the wound and into a collection canister. The vacuum can be adjusted to regulate the strength of the suction (from -125 to -75 mmHg, depending on the patient and the wound being treated) and the length of time.
Dressings must be changed regularly during treatment. Removal and changing of dressings is usually pain-free and minimizes damage to any new skin forming around the healing wound; however, patients can experience varying of levels of pain during NPWT, depending on the location and type of wound, so pain medications are often used alongside this therapy.
Important considerations
Negative pressure therapy can be a highly effective, efficient and economical way of treating complex and chronic wounds IF:
Healthcare providers are properly trained on procedures and use of all equipment
The wound is routinely checked for any signs of infection or change
The dressing around the wound remains clean and is regularly changed
The drainage tubes are connected properly to the collection canister
Drainage is flowing correctly into the canister (e.g., the tubes are not clogged, bent or blocked in any way) and the negative pressure seal is intact
The collection canister is monitored and changed regularly
For more information about negative pressure wound therapy and continuing education courses on NPWT for healthcare and insurance professionals, please contact The Wound Vac Company.
Copy of Lidocaine and Wound Management
Benefits of using lidocaine for wound care and treatment.
The Use of Lidocaine in Managing Wounds
by Aletha Tippett, MD
What is Lidocaine?
Aletha Tippett, MD
Lidocaine is typically used to reduce sensation in tissue in a specific area. Lidocaine can be either injected or applied topically, depending on need. This topical anesthetic is popular because of its low cost and minimal side effects. Once applied, lidocaine typically takes about four minutes to begin affecting sensation, and effects can last for between a half hour and three hours, depending on dosage. One of the main benefits of lidocaine is its rapid onset of action; while stronger or longer-acting substances may be preferred for surgical procedures, lidocaine’s fast-acting nature makes it perfect for reducing pain in a wound.
Lidocaine has been my go-to product for wound care for over 20 years. I always use viscous lidocaine applied to any dressing. A patient might need systemic pain relief also, but the application of topical lidocaine is very effective to help alleviate local pain of wounds. Since I have used lidocaine so long for thousands of wounds I can say it definitely helps the healing of wounds. Having a nearly 100% healing rate speaks to that.
The newest thing that I found out about lidocaine was recently published in Wounds regarding lidocaine's bacteriostatic properties. A study was conducted with surgical wounds, some had lidocaine applied, others had saline applied. The post-surgical infection rate with the lidocaine wounds was much less than the wounds with saline application. This tells me why I rarely had wound infections in all the years treating wounds with lidocaine.
Tips for the Application of Lidocaine
To use lidocaine to treat pain in a wound, just apply a small amount, about 1-2 grams, of oral viscous lidocaine to the dressing. then apply this side to the wound. Because of its viscous nature, lidocaine can be used on any type of dressing. Apply the side of the dressing with the lidocaine to the wound. The affects should begin within a few minutes, providing pain relief to your patient. Change daily or as needed and provide further systemic pain relief if necessary.
So, if you have not used lidocaine for wound care, consider starting to use it. You will be very happy with the outcome.
Note: Aletha Tippett, MD, is a family medicine and wound care expert, founder and president of the Hope of Healing Foundation®, a family physician, and international speaker on wound care. This article was originally published as part of the WoundSource Trending Topics series; permission for its use on this blog was provided by the author.
References
1. Lidocaine Hydrochloride (Local)". The American Society of Health-System Pharmacists. Archived from the original on 2015-09-06. Retrieved Aug 26, 2015.
2. WHO Model List of Essential Medicines (19th List)" (PDF). World Health Organization. April 2015. Archived (PDF) from the original on 13 December 2016. Retrieved 8 December 2016.
3. "Lidocaine HCL". International Drug Price Indicator Guide. Retrieved 27 August 2015.
4. J. P. Nolan & P. J. F. Baskett (1997). "Analgesia and anaesthesia". In David Skinner, Andrew Swain, Rodney Peyton & Colin Robertson. Cambridge Textbook of Accident and Emergency Medicine. Project co-ordinator, Fiona Whinster. Cambridge, UK: Cambridge University Press. p. 194. ISBN 9780521433792. Archivedfrom the original on 2017-09-08.
Lidocaine and Wound Management
Benefits of using lidocaine for wound care and treatment.
The Use of Lidocaine in Managing Wounds
by Aletha Tippett, MD
What is Lidocaine?
Aletha Tippett, MD
Lidocaine is typically used to reduce sensation in tissue in a specific area. Lidocaine can be either injected or applied topically, depending on need. This topical anesthetic is popular because of its low cost and minimal side effects. Once applied, lidocaine typically takes about four minutes to begin affecting sensation, and effects can last for between a half hour and three hours, depending on dosage. One of the main benefits of lidocaine is its rapid onset of action; while stronger or longer-acting substances may be preferred for surgical procedures, lidocaine’s fast-acting nature makes it perfect for reducing pain in a wound.
Lidocaine has been my go-to product for wound care for over 20 years. I always use viscous lidocaine applied to any dressing. A patient might need systemic pain relief also, but the application of topical lidocaine is very effective to help alleviate local pain of wounds. Since I have used lidocaine so long for thousands of wounds I can say it definitely helps the healing of wounds. Having a nearly 100% healing rate speaks to that.
The newest thing that I found out about lidocaine was recently published in Wounds regarding lidocaine's bacteriostatic properties. A study was conducted with surgical wounds, some had lidocaine applied, others had saline applied. The post-surgical infection rate with the lidocaine wounds was much less than the wounds with saline application. This tells me why I rarely had wound infections in all the years treating wounds with lidocaine.
Tips for the Application of Lidocaine
To use lidocaine to treat pain in a wound, just apply a small amount, about 1-2 grams, of oral viscous lidocaine to the dressing. then apply this side to the wound. Because of its viscous nature, lidocaine can be used on any type of dressing. Apply the side of the dressing with the lidocaine to the wound. The affects should begin within a few minutes, providing pain relief to your patient. Change daily or as needed and provide further systemic pain relief if necessary.
So, if you have not used lidocaine for wound care, consider starting to use it. You will be very happy with the outcome.
Note: Aletha Tippett, MD, is a family medicine and wound care expert, founder and president of the Hope of Healing Foundation®, a family physician, and international speaker on wound care. This article was originally published as part of the WoundSource Trending Topics series; permission for its use on this blog was provided by the author.
References
1. Lidocaine Hydrochloride (Local)". The American Society of Health-System Pharmacists. Archived from the original on 2015-09-06. Retrieved Aug 26, 2015.
2. WHO Model List of Essential Medicines (19th List)" (PDF). World Health Organization. April 2015. Archived (PDF) from the original on 13 December 2016. Retrieved 8 December 2016.
3. "Lidocaine HCL". International Drug Price Indicator Guide. Retrieved 27 August 2015.
4. J. P. Nolan & P. J. F. Baskett (1997). "Analgesia and anaesthesia". In David Skinner, Andrew Swain, Rodney Peyton & Colin Robertson. Cambridge Textbook of Accident and Emergency Medicine. Project co-ordinator, Fiona Whinster. Cambridge, UK: Cambridge University Press. p. 194. ISBN 9780521433792. Archivedfrom the original on 2017-09-08.
Wounds & Wound Healing – Part III
In this third post in our series on wound types and treatments, we’ll take a look at how negative pressure wound therapy can be used to treat complex open wounds.
In Part II of our short series on wound types and wound healing, we looked at the complications that can occur in open wounds, including infections.
In this final post in our three-part series, we’ll take a brief look at NPWT – negative pressure wound therapy – and how it can be used to treat complex open wounds.
Open Wounds and Negative Pressure Wound Therapy (NPWT)
As we noted in Part II of our wound care series, in open wounds, the skin is broken or damaged in some way, leaving the underlying area open to the air. This leaves the body exposed to potential contaminants such as dirt and bacteria, which can result in infection. Left untreated – or treated incorrectly – these infections can lead to life-threatening complications.
Over the past 20 years, negative pressure wound therapy (NPWT) has become a leading technology in the treatment of open wounds. To heal properly, open wounds need just the right amount of moisture, to be protected from infection, and – in larger, more complex wounds – help in bringing tissues back together while the skin closes. NPWT, when used properly, does all of these things.
Negative pressure wound therapy works by applying carefully controlled suction to an open wound using a special vacuum pump, hence the name “wound vac” for the control unit. The suction delivers negative pressure evenly through a dressing, such as foam or gauze.
Drainage from the wound is removed using tubing, which adheres to the dressing and is deposited into a collection canister. The dressing, suction and fluid removal also help protect the area from outside contaminants, pulling them away from the wound.
During this process, NWPT increases blood flow to the wound area and provides oxygen to the wound while removing excess fluid, so that the wound has just the right amount of moisture and can close and heal properly.
Use of NPWT
Negative pressure wound therapy can be used for a wide variety of complex open wounds, including:
Traumatic wounds, such as combat or gunshot wounds
Post-surgical wounds
Pressure ulcers (bedsores)
Diabetic ulcers
Skin grafts
When used correctly, negative pressure wound therapy serves as a powerful wound healing tool. However, it is not the right choice for every patient and it is imperative that medical staff be carefully and properly trained in the use of NPWT equipment and procedures.
Even an incorrect application of NPWT dressing can put patients at risk. Healthcare staff must ensure that when NPWT is used, the appropriate dressing and correct suction settings are in place and that they are frequently monitoring both the patient and the wound.
For more information on the proper use of NPWT and licensed training for medical staff, please contact us.
Wound Types & Wound Healing: Part II
A brief look at complications that can arise with open wounds, including common signs of infection.
In Part I of our short series on wound types and wound healing, we looked at the two main types of wounds, open and closed, and the main categories of open wounds.
Since closed wounds are not treated using wound vacs – or negative pressure wound therapy – we’ll focus in this article on the types of complications that can occur with open wounds.
Open Wound Complications
In open wounds, the skin is broken, cut or split in some way. This leaves the underlying tissue – and potentially bone, muscle and organs – open to the air, which can result in problems with overall healing.
Most small, minor wounds can be treated at home by washing the area carefully with soap and water, using a mild disinfectant to remove dirt and debris, and applying a sterile dressing or bandage to cover the area. Depending on the cause and severity, many small wounds will heal on their own in a few days or weeks.
However, even small wounds can develop serious problems. Let’s take a look at some signs of open wound complications.
Infections
Many open wounds happen due to accidents and are caused by objects that puncture or break the skin, such as metal nails or edges, knives, broken glass, teeth, wooden splinters, etc. These objects are often dirty and can carry bacteria or other organisms that get under the skin and enter the surrounding blood or tissue.
However, it’s possible for infection to occur in any open wounds, including surgical incisions.
If an open wound becomes infected, symptoms can include:
· Redness, red streaks or swelling – Initially, there may be some redness and swelling around the opening of the wound, which is normal, but if the color worsens, streaks develop (also known as lymphangitis), or swelling increases, it usually means that infection is present.
· Fluid, pus or draining from the wound – Again, it’s normal to have some clear or slightly yellow drainage, especially from surgical wounds, but if the color turns cloudy, greenish or dark, or if the area has a strong odor, this indicates a problem.
· Heat or warmth – If infection is present, the body will send additional blood cells to the surrounding area to help fight it. This can make the skin feel warm.
· Increased pain – There is often mild to severe pain at a wound site when an injury, accident or surgery takes place. However, this pain should decrease over time. Sudden or worsening pain at the site usually indicates a problem.
· Feeling sluggish, tired or feverish – A fever of over 100° for several hours, or an ongoing feeling of malaise, usually indicates that the body is trying to fight off infection.
In addition, if a wound is not healing and improving over time, this usually indicates that there may be infection present.
Severe infections in an open wound can result in problems such as lockjaw (caused by tetanus bacteria), gangrene (caused by a variety of bacteria, including Clostridium and Streptococcus), and sepsis.
Wound closing and healing
To heal properly, open wounds need just the right amount of moisture and to be protected from infection while closing.
Small wounds can be covered or closed with small adhesive strips or sterile bandages. Larger wounds, however, may require stitches, staples or other treatments to help them close and to prevent infection. Closing the wound brings separated tissue together to promote the healing process.
When treating complex open wounds, there are a variety of treatments that may be used to help the area heal. In the final post of our short series on wound types and healing, we’ll take a look at how negative pressure (NPWT) can be used to help treat and close complex open wounds.
Interested in learning more about wound vacs and NPWT? Contact The Wound Vac Company today.
Note: Important material for this article came from woundcarecenters.org.
Jim Nabors Would Just Cry
A look at Indiana health care and reporting of pressure ulcers (bedsores).
by Dr. Michael Miller
For those of you not as familiar with the Hoosier State as you should be, I used to think it was essentially paradise. Jim Nabors of Gomer Pyle fame is our ubiquitous, tuneful icon with his always well-received “Back Home in Indiana” as a mantra to that source of pride. Our former Governor “My Man” Mitch Daniels was a genius who, using a combination of intelligence, common sense and the persuasive powers of a midwest Svengali, created an economic model that our neighbors can only lust after. Our medico-legal climate is among the best in the US and well it should be.
However, while there are some extraordinary caregivers and facilities here, a recent US News and World Report curiously showed that almost none of our hospitals made their “Best of” lists in any category. That is not to say there is bad care, but to not have a single facility in an entire state even achieve an honorable mention gives one pause to reflect. The state newspapers were notoriously quiet on this concerning fact, despite their trumpeting of who does what well, when and where.
To give an insight into why this may have happened, I offer the following. Several years ago, our Department of Health created a pressure ulcer task force initiative designed to establish guidelines, which were intended to improve prevention, treatment and reporting. There was a great hullabaloo from the department and the many entities invited to participate regarded the creation of this work as a pressure ulcer paper messiah.
Of course, you must remember that development of pressure-based tissue injuries that are currently called Stage 3 and Stage 4 are to be reported to CMS as they are now considered NEVER EVENTS. (Dare I use this moment to prognosticate my next blog discussing the complex, stupid and illogical systems currently used to “Stage” these?) And more, these numbers are to be reported as part of a medical errors reporting system.
There is a generally acknowledged fact that for better or worse, despite the very rare “unpreventable” pressure-based tissue injuries, the development of a pressure ulcer in a hospital is as ubiquitous as Facebook lurkers. With approximately 200 acute care facilities, even the most optimistic (and deluded) health care professionals I have spoken with offer numbers anywhere from five (5) Stage 3 and 4 pressure-based tissue injuries up to 200 per month. Nobody has suggested fewer and there have actually been some who thought there were more. Simple mathematics, using even the low number, would result in approximately 12,000 bedsores developing right here in the Hoosier State (5 bedsores x 200 hospitals x 12 months).
And so, to cut to the chase, the most recent report from our Indiana Department of Health for medical errors in 2013 was recently published. It identified the names and numbers regarding the facilities that honestly disclosed their medical errors (based on mandates with severe, punitive actions for failing to do so). Forty-five bedsores were reported!! Moreover, the officials in charge of this program were outraged because the prior year, there had been 30 reported, which demonstrated a 50% increase!
At this point, I will pause and allow you to re-hinge your jaw from the unquestionable drop it took. 45 bedsores, a 50% increase from a year prior and a national report on health care performance demonstrating that there may be health care here, but it is probably better almost anywhere else? And so, regardless of the veracity of these numbers, they still mandated action.
Of course, the powers that be plodded explosively into action announcing new programs to improve care. When my children were naughty, they were punished. When they lied about being naughty, the punishment increased. Closing my eyes, plugging my ears and telling my wife that I will be creating initiatives to improve their behavior sounds good, but trying to put a patch on a badly broken and dysfunctional wheel is simple bureaucratic buffoonery.
IS the grass greener on your side of the wound dressing? What is your state up to in terms of pressure ulcer prevention, treatment and reporting? As far as our state song sung with such vim and vigor by Jim …perhaps the title needs to be, “Back home anywhere but Indiana.”
Until we ramble together next time.
Dr. Michael Miller is Board Certified in General Surgery by the American Osteopathic Association and initially received his 10-year certification in wound care by the American Academy of Wound Management in 2000 and the American Professional Wound Care Association in 2005.
His practice has been devoted exclusively to wound care and related issues since 1998. He is one of very few full-time physician wound care specialists in the State of Indiana, as well as the U.S. He has published numerous articles in peer-reviewed journals, written chapters in wound care texts, and presented poster exhibits and podium presentations at numerous domestic and international conferences.
Dr. Miller is also a consultant to numerous companies in the wound care industry and provides expert consultations to professionals in the investment and legal industries. In addition to his clinical practice, he owns several patents on wound care devices. Dr. Miller was named the American Osteopathic Foundation's 2010 Physician of the Year.
If All You Have is a Hammer, What Do You Do When You Run Out of Nails?
A look at wound care and pain management, and the factors involved in finding the right solutions for different patients.
by Dr. Michael Miller
Over the years of making house calls for wound care, I found that there was a real need for home-based mental health and behavioral care, palliative care, podiatry and lots of other things. We cater to those who are homebound based on the classic definition involving the word “taxing." One of the more prevalent problems affecting all patients involves the nebulous, but ubiquitous, nerve-jangling, aptly named “5th Vital Sign," namely pain.
As a part of my medical group, we have created a program that provides pain management not just to the homebound, but all those whose lives and lifestyles are affected adversely by it. The program is a monument to government bureaucracy, involving multiple layers of paperwork, mental health evaluations, testing of bodily fluids for both illegal and legal substances, and then, the actual evaluation of the patient commences. After all hurdles are vetted and then jumped, then and only then does a prescription for the appropriate nostrum leave the pad.
In wound care, we treat based on the etiology, the location, the related factors, the amounts of drainage, the surrounding tissues and so on, ad nauseum. Not surprisingly, in pain management, the scenario is much different. In wound care the mantra of the dabbler is see the hole, fill the hole. In pain management, the goal is to minimize pain to maximize functionality but the overriding questions are how this is accomplished.
If the ends justify the means, then why not use explosives to kill flies? A recent conversation with a local healer points out that same mentality that has made millions for Bud Light. Their now-famous slogan, “It’s only weird if it doesn’t work,” demonstrates the relationships assumed by disillusioned sports fanatics whose bizarre actions, foods, etc., seem to provide a direct correlation to touchdowns and field goals. Our discussion regarded a quadriplegic patient with no sensation below C5. The “Healer” had kept him on oral narcotics for years because of his “pain." The spirited but limited discussion ended up with his telling me that he had been using narcotics as his main source of pain control for years, that he had a relative with pain management experience whom he consulted “when needed," and that his many years of training included that of pain management.
His reason for the consult to my pain service was that he recognized that in today’s cause célèbre pain management climate, that one single narcotic slip might result in a major fall. I elected to press the issue by asking him why he didn’t just give all his hypertensives one medicine, his infected denizens one antibiotic and why he did not simply write for morphine across the analgesic board since they all worked and that was much easier than actually making a diagnosis regarding specificity. He responded by simply stating that his training provided him sufficient impetus to do as he had been. My thought was that the incomprehensible and confused logic he promoted regarding the differences between nociceptive and neuropathic pain may have been because both start with the letter “N” rather than any actual physiologic differences.
I accepted the consult on behalf of the group and he was genuinely appreciative. The fact that he requested the consult when he was perfectly able to do so himself (at least in his mind) suggests that a schism of major proportions had erupted in his cranium – namely, that of doing what worked versus doing what was physiologically correct but more appropriate.
The indiscriminate, unguided, “I have done it this way for years” mentality does not demonstrate expertise but rather the insipid, pseudo-intellectual detritus of a wound care or pain management Jonathan Gruber.
What I use to treat a patient for their wounds or their pain is based on a myriad of factors – the least of which is “I’ve always done it that way." In my mind, the real question to be considered is, “If one size fits all, then what size is 'ALL?' ”
Until we ramble again.
Dr. Michael Miller is Board Certified in General Surgery by the American Osteopathic Association and initially received his 10-year certification in wound care by the American Academy of Wound Management in 2000 and the American Professional Wound Care Association in 2005.
His practice has been devoted exclusively to wound care and related issues since 1998. He is one of very few full-time physician wound care specialists in the State of Indiana, as well as the U.S. He has published numerous articles in peer-reviewed journals, written chapters in wound care texts, and presented poster exhibits and podium presentations at numerous domestic and international conferences.
Dr. Miller is also a consultant to numerous companies in the wound care industry and provides expert consultations to professionals in the investment and legal industries. In addition to his clinical practice, he owns several patents on wound care devices. Dr. Miller was named the American Osteopathic Foundation's 2010 Physician of the Year.