by Caroline Fife, M.D. | Apr 16, 2021 | Fight the Good Fight, Lymphatic Imaging & Lymphedema
This is a healthy teenager who underwent podiatric surgery for a tarsal coalition 6 months ago. Sutures were removed a month later and two weeks after that, a small opening along the surgical incision began to drain copious amounts of “egg yolk” colored...
by Caroline Fife, M.D. | Apr 15, 2021 | Fight the Good Fight, Uncategorized
I ask my nurses to leave the discarded dressings on top of the trashcan so that I can have a look at them. There’s a lot you can learn from used dressings. I am worried about the fact that drainage can be copious despite compression, that patients on oral...
by Caroline Fife, M.D. | Apr 14, 2021 | Do the Right Thing: Thoughts on Quality, Fight the Good Fight, Nutrition & Wound Healing, US Wound Registry
This is a young man in his 20’s who is a quadraplegic and suffered a bowel obstruction about 6 months before this photograph was taken. The midline abdominal wound is granulated, but still hasn’t epithelialized. Why? There’s no pressure over this area and it doesn’t...
by Caroline Fife, M.D. | Apr 13, 2021 | Fight the Good Fight
We don’t talk enough about the relationship between sleep apnea and lower extremity edema. A lot of patients fall asleep while I am talking to them, and I don’t think the problem is my personality. Edema is THE most common diagnosis we see in the outpatient...
by Caroline Fife, M.D. | Apr 5, 2021 | Fight the Good Fight
Join us Thursday, April 8, 2021 from 5:30 – 7:30 PM EST for the second installment of Virtual Wound Rounds, in partnership with SAWC. The topic is “The Dressing Debate Part II: Advanced Dressings – Why and When?” The webinar is free! All you...
by Caroline Fife, M.D. | Mar 30, 2021 | Fight the Good Fight, Health Information Technology and Wound Care, Nutrition & Wound Healing
There’s increasing interest in Vitamin D. I became focused on this after a series of patients who failed to heal operative wounds. I found their Vitamin D-OH levels were in the teens (in some cases, single digits) when 30 is the lowest value we want for wound healing....
by Caroline Fife, M.D. | Mar 9, 2021 | COVID-19, COVID-19 & HBOT, Fight the Good Fight
Check out this excellent review article on the “Physiologic and biochemical rationale for treating COVID-19 patients with hyperbaric oxygen,” by the Research Committee of the Undersea and Hyperbaric Medical Society (UHMS) and published in Undersea and Hyperbaric...
by Caroline Fife, M.D. | Mar 5, 2021 | Fight the Good Fight, Pressure Cooker: Rethinking Pressure Ulcers
In 2019 when Dr. Gksoulias and I published “On the Origin of Intraoperative Pressure Injury: An Angiosomal Theory of Pressure Injury Formation,” I didn’t make a big deal about the photo above, but I think it’s time to talk about it. To look at this heel pressure...
by Caroline Fife, M.D. | Mar 3, 2021 | Fight the Good Fight, Pressure Cooker: Rethinking Pressure Ulcers
Over the years, I have created a few videos on my YouTube channel from serial photographs to show how Deep tissue injuries (DTI) and stage 4 pressure ulcers form from the inside out — at least, that’s what it looks like in these photos — although I can’t...
by Caroline Fife, M.D. | Mar 2, 2021 | Fight the Good Fight, Pressure Cooker: Rethinking Pressure Ulcers
Yesterday I posted a new pressure ulcer case report authored by Jenny Alderden, Dr. Tracey Yap and myself, which provides new evidence for the “inside out” vascular infarction theory of severe pressure ulcer formation (and which also explains Stage 1 pressure...
