This month, we’d like to showcase two highly respected physicians helping patients with chronic wounds at St. Luke’s Hospital. Sion Levy, MD and Shari Kaminsky, DPM, evaluate wounds from a whole body point of view with a multidisciplinary approach that includes comprehensive wound care, surgical intervention, infection control treatment and hyperbaric oxygen therapy. St. Luke’s is the first and only hospital in the area to offer comprehensive and acute emergency hyperbaric services.
Q: Since you started practicing in the St. Louis area more than 25 years ago, what kinds of changes have you seen within your community in terms of diabetes diagnoses?
A: The community I serve seems to have higher rates of diabetes mellitus diagnoses. My patients’ average BMI is increasing. I also find difficulty with insurance covering many types of medications and durable medical equipment.
Q: What new diabetic foot ulcer (DFU) treatments are changing the way that patients heal?
A: The way amniotic wound dressings are improving. The outcome of the Slow to Heal diabetic foot wound. Negative Pressure Wound Therapy (NPWT) comes in many varieties for different situations. The use of Total Contact Casting has become much easier due to fast application techniques.
Q: What’s the biggest challenge for physicians today in the world of wound care? Why?
A: In my opinion, the biggest challenge in the world of wound care is patient compliance. Healing chronic wounds is a process in which a lot of the patient’s progress depends on adherence to a prescribed regimen. Common issues include compliance with compression therapy and offloading. That is why patient education at the wound center is of the most importance.
Q: Since it’s Diabetes Month, we’d like to ask about self-care. When a patient comes to you with a hard-to-heal, at-risk wound, what can they do for themselves to help their wound heal more quickly - and stay that way?
A: Treating diabetic wounds is undoubtedly a multi-disciplinary process. Specifically, collaboration with the patient’s endocrinologist or primary care provider is important to achieve optimal blood glucose control. Additionally, the majority of these patients will require custom footwear for offloading their wounds. Coordination with the patient’s podiatrist and/or orthotist is essential. Diabetic wound patients can help themselves heal more quickly by having a multi-disciplinary team approach and actively participating in their care. Specifically, in diabetic foot wounds, good glycemic control & offloading are imperative.