Wound Care Q&A
Our expert panelists expound on the treatment of pressure ulcers, including the use of calcanectomies, nutritional supplements and negative pressure wound therapy (NPWT).
Q:
Do you routinely perform partial or subtotal calcanectomies for severe heel ulcers?
A:
David Armstrong, DPM, PhD, MD, routinely performs calcanectomies, most often combining them with some element of vascular intervention.... Read More.
Our expert panelists offer essential keys to diagnosis, share their insights on offloading modalities, and discuss mattresses and beds to help resolve pressure issues.
Q:
What is your diagnosis and treatment approach when you see a new patient with a pressure ulcer in lower extremities?
A:
Ronald Sage, DPM, notes most pressure or decubitus ulcers of the foot involve the heel. On occasion, they... Read More.
Offering insights and perspectives on prescribing medication for patients with painful wounds, these expert panelists discuss drugs for neuropathic pain, extended-release narcotics and how to be wary of pain medication “seekers.”
Q:
Do you use gabapentin (Neurontin, Pfizer), pregabalin (Lyrica, Pfizer), or duloxetine (Cymbalta, Eli Lilly) and other medications for neuropathic pain?
A:
“I would... Read More.
These panelists discuss identifying the etiology of pain in patients with wounds and share their perspectives on various treatment modalities ranging from nonsteroidal anti-inflammatory drugs (NSAIDs) to the use of regional nerve blocks before surgery.
Q:
How do you approach wound care patients when they complain of wound pain?
A:
As Eric Lullove, DPM, explains, sometimes patients with wounds... Read More.
These knowledgeable panelists provide insights on using appropriate codes for wound debridement and skin substitutes to maximize reimbursement. They also address the correct use of modifiers and offer coding pearls for those entering practice.
Q:
What is the right way to bill for wound debridement in the office and in the OR?
A:
For wound debridement, Anthony Poggio, DPM, suggests describing... Read More.
Providing salient examples and insights from their experience, the expert panelists discuss proper documentation, coding for E&M services and appropriate use of modifiers.
Q:
What is the key to proper coding and documentation in wound care practices?
A:
As Harry Goldsmith, DPM, emphasizes, proper documentation allows the wound care specialist and others treating the patient to evaluate the... Read More.
These expert panelists debate the use of antimicrobial dressings versus regular wound dressings, the efficacy of antiseptics and whether sterile gloves are useful in reducing the risk of infection.
Q:
Do you use any antiseptic, such as alcohol, hydrogen peroxide, Dakin’s solution or povidone-iodine solution for wounds?
A:
Although he notes that the above listed antiseptics are toxic to wounds... Read More.
Given the delicate nature of the wound environment, one must be vigilant in reducing the incidence of perioperative infection. Accordingly, these expert panelists discuss skin preparation before surgery, the use of prophylactic antibiotics, hand hygiene protocol and wound irrigation techniques.
Q:
What do you use for skin preparation prior to foot and ankle surgery?
A:
Desmond Bell, DPM, CWS,... Read More.
Fungal infections can exacerbate the already compromised environment of lower extremity wounds. These expert panelists discuss treating fungal infections in wound care patients, offering insights on oral treatments, topical therapies, and the potential of lasers.
Q:
Do you treat fungal skin and nail disease in lower extremity wound patients?
A:
For Brent Haverstock, DPM, the decision to treat... Read More.
Any open wound is a portal of entry for bacteria and there is a possibility of wound infection, oftentimes with gram-positive bacteria, such as Staphylococcus or Strep species. It is very important to diagnose and treat these conditions swiftly in order to achieve optimal outcomes. Accordingly, our expert panelists explore how to diagnose and treat wound infections, offering a variety of insights... Read More.
When considering which methods of wound debridement will be effective in their patients, clinicians have a wide range of choices at their disposal. These expert panelists discuss their preferences for sharp debridement, ultrasound debridement, non-surgical debridement and the use of maggots.
Q:
What are your favorite sharp debridement tools of your choice and why?
A:
Kazu Suzuki, DPM, CWS,... Read More.
Wound debridement is the foundation for successful and swift wound healing. Appropriate and timely wound debridement facilitates infection control by removing the biofilm over wound surfaces. Our expert panelists discuss best practices in wound debridement by reviewing the clinical evidence for wound debridement, patient education and insights on the vascular workup of patients with wounds.
Q:... Read More.
_sm.jpg)
