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Text and Atlas of Wound Diagnosis and Treatment Hamm_FM_i-xviii.indd i 18/12/14 11:13 AM NOTICE Medicine is an ever-changing science. As new research and clinical experience broaden our knowledge, changes in treatment and drug therapy are required. The authors and the publisher of this work have checked with sources believed to be reliable in their efforts to provide information that is complete and generally in accord with the standards accepted at the time of publication. However, in view of the possibility of human error or changes in medical sciences, neither the authors nor the publisher nor any other party who has been involved in the preparation or publication of this work warrants that the information contained herein is in every respect accurate or complete, and they disclaim all responsibility for any errors or omissions or for the results obtained from use of the information contained in this work. Readers are encouraged to confirm the information contained herein with other sources. For example and in particular, readers are advised to check the product information sheet included in the package of each drug they plan to administer to be certain that the information contained in this work is accurate and that changes have not been made in the recommended dose or in the contraindications for administration. This recommendation is of particular importance in connection with new or infrequently used drugs. Hamm_FM_i-xviii.indd ii 18/12/14 11:13 AM Text and Atlas of Wound Diagnosis and Treatment Edited by Rose L. Hamm, PT, DPT, CWS, FACCWS Assistant Professor of Clinical Physical Therapy Division of Biokinesiology and Physical Therapy Ostrow School of Dentistry University of Southern California Los Angeles, California New York Chicago San Francisco Athens London Madrid Mexico City Milan New Delhi Singapore Sydney Toronto Hamm_FM_i-xviii.indd iii 18/12/14 11:13 AM Copyright © 2015 by McGraw-Hill Education. All rights reserved. Except as permitted under the United States Copyright Act of 1976, no part of this publication may be reproduced or distributed in any form or by any means, or stored in a database or retrieval system, without the prior written permission of the publisher, with the exception that the program listings may be entered, stored, and executed in a computer system, but they may not be reproduced for publication. 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Under no circumstances shall McGraw-Hill Education and/or its licensors be liable for any indirect, incidental, special, punitive, consequential or similar damages that result from the use of or inability to use the work, even if any of them has been advised of the possibility of such damages. This limitation of liability shall apply to any claim or cause whatsoever whether such claim or cause arises in contract, tort or otherwise. This book is dedicated to my late husband, Dr. David Hamm, Jr., who inspired me with his instinctive and well-recognized ability to diagnose subtle and often rare disorders, not by reading the chart but by listening to and looking at the patient. He loved medicine, was devoted to his patients, and cared for them with compassion and authenticity. Whenever a professional opportunity was presented to me, Dave supported me with a hearty “Go for it!” He would be pleased with this effort and his spirit encouraged me every step of the way. Hamm_FM_i-xviii.indd v 18/12/14 11:13 AM This page intentionally left blank Reviewers Jaimee Haan, PT, CWS Donald E. Mrdjenovich, DPM, CWS, FACCWS Team Leader Physical Therapy Wound Management Indiana University Health Indianapolis, Indiana Central PA Podiatry Associates, PC Altoona, Pennsylvania Sharon Lucich, PT, CWS Indiana University Health Methodist Hospital Methodist Wound Center Adjunct Faculty Indiana University School of Health and Rehabilitation Sciences Department of Physical Therapy Indianapolis, Indiana Laurie M. Rappl, PT, DPT, CWS Medical Science Liaison Cytomedix, Inc. Gaithersburg, Maryland vii Hamm_FM_i-xviii.indd vii 18/12/14 11:13 AM This page intentionally left blank Contents Contributors Foreword Preface Acknowledgments xi xiii xv xvii 10. Burn Wound Management 11. Factors That Impede Wound Healing PA R T O N E Integumentary Basics PA R T T H R E E 3 Wound Bed Preparation 12. Wound Debridement 2. Healing Response in Acute and Chronic Wounds Tammy Luttrell, PT, PhD, CWS, FACCWS 15 3. Evaluation of the Patient with a Wound 67 PA R T T W O 97 4. Vascular Wounds 99 Michael Sigman, MD Christian Ochoa, MD Vincent L. Rowe, MD, FACS 13. Wound Dressings 143 165 Aimée D. Garcia, MD, CWS, FACCWS Stephen Sprigle, PhD, PT 193 Pamela Scarborough, PT, DPT, CDE, CWS, CEEAA James McGuire, DPM, PT, CPed, FAPWHc 8. Atypical Wounds Nicolas D. Hamelin, MD, DMV, MBA, FRCSC Alex K. Wong, MD, FACS Biophysical Technologies 14. Electrical Stimulation 15. Negative Pressure Wound Therapy 385 387 401 Karen A. Gibbs, PT, PhD, DPT, CWS Rose L. Hamm, PT, DPT, CWS, FACCWS 16. Ultrasound 423 Karen A. Gibbs, PT, PhD, DPT, CWS Rose L. Hamm, PT, DPT, CWS, FACCWS 17. Pulsed Lavage with Suction 439 Karen A. Gibbs, PT, PhD, DPT, CWS Rose L. Hamm, PT, DPT, CWS, FACCWS 18. Hyperbaric Oxygen Therapy 451 Lee C. Ruotsi, MD, CWS, UHM 227 Jayesh B. Shah, MD, CWSP, FACCWS, FAPWCA, FUHM, FAHM Rose L. Hamm, PT, DPT, CWS, FACCWS 9. Flaps and Skin Grafts 343 Dot Weir, RN, CWON, CWS C. Tod Brindle, MSN, RN, ET, CWOCN Karen A. Gibbs, PT, PhD, DPT, CWS Rose L. Hamm, PT, DPT, CWS, FACCWS Marisa Perdomo, PT, DPT, CLT-Foldi, CES Rose L. Hamm, PT, DPT, CWS, FACCWS 7. Diabetes and the Diabetic Foot 319 PA R T F O U R Wound Diagnosis 6. Pressure Ulcers 317 Dot Weir, RN, CWON, CWS Pamela Scarborough, PT, DPT, CDE, CWS, CEEAA Rose L. Hamm, PT, DPT, CWS, FACCWS 5. Lymphedema 297 Rose L. Hamm, PT, DPT, CWS, FACCWS Tammy Luttrell, PT, PhD, CWS, FACCWS 1 1. Anatomy and Physiology of the Integumentary System Rose L. Hamm, PT, DPT, CWS, FACCWS 281 Gabrielle B. Davis, MD, MS Joseph N. Carey, MD, FACS Alex K. Wong, MD, FACS 19. Ultraviolet C 475 Jaimee Haan, PT, CWS Sharon Lucich, PT, CWS 255 20. Low-Level Laser Therapy 483 Jaimee Haan, PT, CWS Sharon Lucich, PT, CWS Index 489 ix Hamm_FM_i-xviii.indd ix 18/12/14 11:13 AM