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TUESDAY April 6 , 2004 - Subscribe - Contact Us - Rate Card - Place an Ad Valley&State Backpage O&E Sports Archives Classifieds Faith&Beliefs Obituaries Revels March 26, 2004 Clinic saves more than limbs By Steve Zimmerman Ashland Daily Tidings If Lee Cornutt had his way, the nurses at the Wound Center at Ashland Community Hospital would be granted sainthood. Karen Adams, a wound care continence nurse, treats a diabetic's foot at Ashland Community Hospital. Denise Baratta | Ashland Daily Tidings Cornutt, a diabetic, had a severe wound on his right foot that would not heal. It was looking like Cornutt was going to lose the foot, when in stepped Karen Adams, a certified wound ostomy continence care nurse at the Wound Center who Cornutt calls an angel. Because of her determination, Cornutt's foot was saved. Adams talked about what her duties are on a daily basis. "Part of what I do is wound care," she said. "I see patients on an outpatient basis who are referred by a physician. I work through a doctor under a doctors orders." On any given day, Adams will see problems including lower extremity wounds from diabetes, arterial and pressure ulcers, surgical wounds and people with colostomies and illiostomies. Cornutt's case is one that challenged Adams. He did just about everything a diabetic with an open wound should not do. His attempt at self-healing almost cost him his left foot. "When I first saw him, I received a referral from the medical surgical floor at the hospital," she said. "I was told he had had an I & D (irrigation and debreedment) of a diabetic ulcer on his foot." When Adams took the dressings off, she was shocked and surprised. "I saw the inside of a right foot all the way out to the large toe splayed open. I saw muscle, I saw tendon and I saw bone," she noted. "He was a mess. The surgeon (Dr. Doug Morrison) who did the I & D thought he would end up with an amputation of the foot a few months out." And that could have ultimately led to more surgery in the future. "I think in his situation, with the status of his feet, he probably would have lost his leg from the knee down," Adam said. "That is always a possibility with a diabetic. If they just try to take a little bit, they end up having to go back in for another surgery and have the amputation taken up higher." Adams and her staff started several different types of wound care. Part of that treatment was the VAC, which stand for Vacuum Assisted Closure. "We had to deal with quite a few infections along the way and try to keep him off his feet," Adams said. "That is one of the hardest things to do with a diabetic because they cannot feel the pain. Most diabetics have lost most of the sensation in their feet and that is why the blisters form in the first place." That lack of feeling causes diabetics to not think the injury is important and they keep dealing it as it keeps getting worse. "Mr. Cornutt ended up with something called cellulitis, which is an infection just under the skin's surface," Adams said. "That infection then made its way deeper into the foot and that is what necessitated the surgery." According to Cornutt, Adams is the reason he did not lose his foot. Adams said it was the VAC that did the trick. After Cornutt developed an additional pressure ulcer on his right heel and a wound on his left foot, Adams decided to take a more radical approach, the VAC. "What I did was I set all three of his wounds up on the VAC and connected them to a pump that fits in a little fanny pack around his waist," she explained. "He was able to go about his business. Ideally, I would have liked him to be off his foot but he needed to get out and work and earn money to stay in his home." Cornutt's Office of Medical Assistance Program "Plus" insurance paid for the treatments. Without it, he probably would not have been able to have the treatment. "He is lucky," Adams said. "We are now having trouble getting coverage on OMAP Plus for the VAC. It is expensive as it can be about $140-$150 per day for the rental of the pump and the dressing materials. But for some people, getting the drainage away from the wound is really the only way to get it healed quickly and properly. He had a very highly draining wound and the VAC was the way to go." Cornutt wore the VAC for about 2 1/2 months due to the nature of his wound. Adams saw Cornutt every day at the beginning but now sees him once every three weeks. "I don't, and most wound care nurses don't, put the VAC on a patient unless number one, they have a chronic wound and a wound that is not responding to other forms of treatment," she said "In Lee's case, there is still one little tiny spot on that original wound that just doesn't want to quite close." Adams said other factors weigh in the decision to use the VAC on a patient, such as nutrition, overall health and age. She said she hopes to never see a case like Cornutt's again. "I have been here two years and he was one of my very first patients," she said. "I can safely say his is the worst diabetic foot or feet I have seen." Getting treatment quickly for any open wound is imperative for a diabetic. "I think as human beings, we're all capable of rationalizing that if I clean this, it will go away," Adams explained. "But with a diabetic, they cannot feel the pain and you cannot always see how bad something is from the outside. It is the pain that tells you something worse is going on. "And a lot of times, vision is impaired with diabetes. Trying to get your foot up close enough to your eyes to get a good look at it is a whole different story. I have had diabetics come in and say they think there is something little going on down there. They say it is tender or that they can feel something. With me looking with clear vision, it is obvious there is something pretty nasty going on down there. They just can't see it." DailyTidings.com Home Page Valley&State | Backpage | O&E | Sports | Archives | Weather | Classifieds Columnists | Faith&Beliefs | Obituaries | Revels | Subscribe | Contact Us Copyright 2004 Ashland Daily Tidings and Ottaway Newspapers All Rights Reserved Site Search: The new search is here! Click here for more information. .:Advertisements:. RESOURCES - ODOT Road Cams