Limb Preservation, Amputation service, and Wound...
Transcript of Limb Preservation, Amputation service, and Wound...
Limb Preservation, Amputation service, and
Wound Care
MARK GOETCHEUS, BSN, RN, CWON, CFCN, CDE
WOUND, OSTOMY, LIMB PRESERVATION, & AMPUTEE SERVICES
HARBORVIEW MEDICAL CENTER
May 25th, 2019
CONFIDENTIAL – DO NOT DISTRIBUTE
DISCLOSUREMark Goetcheus, BSN, RN
• No relevant financial relationship reported
Wound, Ostomy, Limb Preservation, & Amputation Services
Mark Goetcheus Holly VanceNikki OertingBrandon Ibarra
Limb Preservation, Amputation service, and Wound Care
Surgical Consolation
• Salvage vs amputation
• Coordination: LP surgical service
• Vascular interventions
• Wound care plan
• Imaging, labs, ABI/TBI’s
• Infection Disease
Limb Preservation, Amputation service, and Wound Care
Amputation Education
• Physical Therapy/ Occupational Therapy
• Prosthetics & Orthotics
• Rehab Psychology
• Rehab Medicine
• Amputee Support Group
Foot care
• Nail and Callus Debridement
• Foot Care Education
Risk of ulceration Education
Fissure subcutaneous hemorrhage Callus
Onychogryphosis (ram’s horn) interdigital spaces 2/2 maceration & friction
Onychocryptosis/ Ingrown toe nail
Wound Care
• Dressing Plan
• Offloading
• Conservative Sharps Debridement
Lower Extremity Amputation Clinical Pathway (Above, Through and Below Knee)
• standardize treatment
• pre-op clinic visit to 10 weeks post-
operation
• includes trauma related procedure
• Multidiscipline approach
• Patient education