Wound Care Q&A

Clinical Editor: Kazu Suzuki, DPM, CWS
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These expert panelists discuss how to offload pressure ulcers in the heel and ankle, which patients are at high risk for pressure ulcers and whether one should debride dry heel eschar. Q: What is your offloading device of choice for heel and ankle pressure ulcers? A: Nicholas Giovinco, DPM, emphasizes that offloading an ambulatory patient poses a great challenge. While total contact casts work... Read More.
Clinical Editor: Kazu Suzuki, DPM, CWS
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Given that offloading is critical to healing wounds in the lower extremity, these panelists discuss assessment techniques for wounds, favored modalities for offloading diabetic neuropathic ulcers and how to document pressure wounds. Q: What is your initial assessment and approach to offloading lower extremity ulcers? A: Kazu Suzuki, DPM, CWS, suggests putting on “an investigator hat” and... Read More.
Clinical Editor: Kazu Suzuki, DPM, CWS
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These insightful panelists offer their expertise on dressings, particularly for wounds that are dry and gangrenous, and wounds with strong odor. They also share their perspectives and insights on painful wounds. Q: What do you use when you see a dry, gangrenous wound? A: When a wound presents with dry gangrene, the most important thing to do is make an immediate referral to a vascular... Read More.
Clinical Editor: Kazu Suzuki, DPM, CWS
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Offering insights on dressing dispensing and obtaining a level of debridement with dressings, these panelists also share their thoughts on wounds ranging from deep tunneling wounds to infected ulcerations in the lower extremity. Q: Do you use mail order delivery or dispense dressings from your office to your patients? A: Kazu Suzuki, DPM, CWS, uses Byram Healthcare, a medical supply company... Read More.
Clinical Editor: Kazu Suzuki, DPM, CWS
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The proper selection of a wound dressing can greatly facilitate wound healing. Accordingly, the panelists share their thoughts on dressing selection, antimicrobial dressings and emerging dressings in wound care. Q: How do you select your dressing in your practice setting? A: John Steinberg, DPM, FACFAS, uses “a very practical approach” to dressings. He stresses the importance of realizing that... Read More.
Clinical Editor: Kazu Suzuki, DPM, CWS
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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.
Clinical Editor: Kazu Suzuki, DPM, CWS
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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.
Clinical Editor: Kazu Suzuki, DPM, CWS
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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.
Kazu Suzuki, DPM, CWS
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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.
Clinical Editor: Kazu Suzuki, DPM, CWS
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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.
Clinical Editor: Kazu Suzuki, DPM, CWS
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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.
Clinical Editor: Kazu Suzuki, DPM, CWS
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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.