by Caroline Fife, M.D. | Apr 21, 2021 | Fight the Good Fight, PAD Hall of Shame
I cannot do wound care without skin perfusion pressure. My machine is broken. If I don’t have one, I can’t do what I do. The hospital says that because the other wound centers use ABI that I should, too. But I see the problems they can’t fix. There is a lot of other...
by Caroline Fife, M.D. | Apr 20, 2021 | COVID-19, Fight the Good Fight
In 1996, Sackett and colleagues published, “Evidence-Based Medicine: What it Is and What it Isn’t.” The incessant drum beat of the “hierarchy of evidence” has caused physicians to forget that the aim of EBM is to, “integrate the experience of the clinician, the...
by Caroline Fife, M.D. | Apr 20, 2021 | Fight the Good Fight, Lymphatic Imaging & Lymphedema
Yesterday I posted an article about a new study just published in the Journal of Vascular Surgery: Venous and Lymphatic Disorders, which shows that the degradation of lymphatic anatomy happens early in venous disease and worsens as venous disease worsens. Check out...
by Caroline Fife, M.D. | Apr 19, 2021 | Fight the Good Fight, Lymphatic Imaging & Lymphedema
A new study just published in the Journal of Vascular Surgery: Venous and Lymphatic Disorders (Vol. 9, Issue 3, May 2021) shows that the degradation of lymphatic anatomy happens early in venous disease and worsens as venous disease worsens. Near-infrared fluorescence...
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....
