by Caroline Fife, M.D. | May 12, 2021 | Fight the Good Fight
This is a 57-year-old woman with rheumatoid arthritis and a non-healing ulcer of the leg for a year, likely due to vasculitis. Traumatizing vasculitic ulcers with sharp debridement often makes them larger (besides being horribly painful) – so it’s generally a...
by Caroline Fife, M.D. | May 11, 2021 | Fight the Good Fight, Nutrition & Wound Healing
This is a man in his mid-eighties with severe peripheral edema and a nasty looking leg ulcer that’s been present for about 2 months. His edema began 2 years ago, some weeks after his wife died. It turns out that he’s lost at least 20 lbs. over the past year. When I...
by Caroline Fife, M.D. | May 10, 2021 | Fight the Good Fight, Pressure Cooker: Rethinking Pressure Ulcers
Check out this podcast interview with Drs. Tracey Yap and Jenny Alderden discussing their recent research on the frequency of repositioning for nursing home patients and the relationship of pressure injuries (PI) to angiosomes. Here’s a link to the related article in...
by Caroline Fife, M.D. | May 6, 2021 | Do the Right Thing: Thoughts on Quality, Fight the Good Fight
Dear Manufacturer of Cellular and/or Tissue-based Products (CTPs) — commonly known as “skin substitutes”: I feel compelled to explain the math of using CTPs in the hospital-based outpatient department (HOPD). A friend who is a podiatrist just told me about the...
by Caroline Fife, M.D. | May 5, 2021 | Fight the Good Fight, Nutrition & Wound Healing
I’ve been talking about how I use IMPACT® in surgical patients who are nutritionally at risk. This is the second patient I tried the approach on. She’s a very beautiful, 33-year-old, previously healthy young woman who developed sepsis with cardiogenic shock and was in...
by Caroline Fife, M.D. | May 4, 2021 | Fight the Good Fight, Nutrition & Wound Healing
I have spent the last several years making nutrition a major focus of my wound care practice, and I think it has revolutionized the way I manage patients. It would be ideal if all my patients could be evaluated by a registered dietician, but unless they have diabetes,...
by Caroline Fife, M.D. | Apr 30, 2021 | Do the Right Thing: Thoughts on Quality, Fight the Good Fight, Nutrition & Wound Healing
This is a 35 y.o. woman with type 1 Diabetes, liver disease and end stage renal disease on home peritoneal dialysis after failed renal and liver transplants. She also has other wounds on her body due to pressure and ischemia. The abdominal wound had been present for 9...
by Caroline Fife, M.D. | Apr 29, 2021 | Fight the Good Fight, PAD Hall of Shame
Wounds are a symptom of disease, and usually the first disease we have to rule out in patients with lower extremity wounds is poor perfusion. Arterial disease is the most common reason, but not the only one. I rely on skin perfusion pressure (SPP) to determine whether...
by Caroline Fife, M.D. | Apr 28, 2021 | Fight the Good Fight, PAD Hall of Shame
Wounds are a symptom of disease, and usually the first disease we have to rule out in patients with lower extremity wounds is poor perfusion. Arterial disease is the most common reason, but not the only one. I rely on skin perfusion pressure (SPP) to determine whether...
by Caroline Fife, M.D. | Apr 27, 2021 | Fight the Good Fight, PAD Hall of Shame
Wounds are a symptom of disease, and usually the first disease we have to rule out in patients with lower extremity wounds is poor perfusion. Arterial disease is the most common reason, but not the only one. I rely on skin perfusion pressure (SPP) to determine whether...
