Fixing the Hard-To-Fix
AAMC Wound Care Center® Offers Specialized Care
On January 3 of this year, Elizabeth Corasaniti had a “funny” accident—as she describes it. “I fell out of my car backing into a parking place at church. It sounds a little strange, I know,” she said. “I was checking to see if I had pulled in far enough before stopping. I took off my seat beat, opened the door to look behind me, and then I put my foot on the gas by accident. Suddenly the car was airborne, and I was on the driveway with my arm skinned from wrist to elbow.”
For Mrs. Corasaniti, 76, who has taken prednisone regularly for years because she suffers with rheumatoid arthritis, a badly skinned arm can be dangerous. Because of the prednisone, her skin is very thin. “Like paper,” she said.
“The ambulance took me to the hospital where I received 15 stitches. The doctor did a beautiful job, but said since my skin was so thin, it might not heal properly,” she said. A few days later when she visited her regular physician, the nurse tried to remove the bandage, but couldn?t without tearing the skin. Mrs. Corasaniti said, “The doctor took a look at it and called the AAMC Wound Care Center. They said to send me right over and they would fit me in. I had no idea there was such a place at Anne Arundel Medical Center.”
“They were just wonderful. I felt at home right away—from the secretary at the front desk to Dr. Jamieson who treated me.” In the course of the two-month treatment, she said, part of the skin that died had to be removed. Mrs. Corasaniti was given Regranex to spur new skin growth and now, only a few months later, there is only a small scar, “and even that is fading,” she said.
Not only did she learn about a valuable asset close to home, she also learned another valuable lesson. “Now I always put the car in park before I undo my seatbelt!” she said.
In its two-and-a-half years of operation, The Wound Care Center® at Anne Arundel Medical Center has grown significantly, with more than 3,000 patient visits last year alone. James Chappell, M.D., F.A.C.S., a cosmetic and reconstructive plastic surgeon, is medical director of the Center. He said the healing rate for wounds is 89.9 percent with an average of 35 days to healing, both of which are better than the national average. “We have a well coordinated team of physicians, nurses and support staff, as well as a multidisciplinary surgical and medical approach. All of these factors help us maintain extremely high success rates with regard not only to healing times and rates, but also patient satisfaction. The fact that we can get most of these very difficult wounds healed reflects our dedication to the patient.”
Dr. Chappell said patients who are referred to the Center have chronic wounds, which means wounds that have not improved significantly in four weeks or healed in eight weeks, or those similar to Mrs. Corasaniti?s that are difficult to treat because of medical history. Wounds treated at the Wound Care Center may be related to a variety of health issues such as diabetes, peripheral vascular disease, chronic immunosuppression (usually organ transplant or severely arthritic patients), lymphedema, venous insufficiency, or difficult post-operative or post-radiation therapy wounds.
Patients are treated with an aggressive wound care program, which includes an overall medical evaluation, weekly wound assessment, debridements and dressing changes. Additional testing is ordered as necessary. For example, circulation studies may be ordered, a vascular or plastic surgeon consulted, blood sugar levels checked and/or nutritional studies performed. “We have to look at the overall medical picture—often times these wounds reflect something going wrong somewhere else, such as the heart or kidneys,” Dr. Chappell said.
The AAMC Wound Care Center is staffed by physicians who have special training in treating complex wounds. The team includes vascular, general and plastic surgeons, podiatrists, and a physical medicine and rehabilitation specialist. In addition, the staff includes nurses, a clinical manager, and a case manager who have extensive training in wound care.