By Mr. Wesley P Elliott (Army Medicine)May 23, 2014
When Diane Scarf's sister developed cancer, she watched her struggle through chemotherapy and a double mastectomy and Scarf knew she was at a high risk for breast cancer herself.
She had several fibrous tissues in her breasts over the years and felt it was just a matter of time.
"I saw what my sister had to go through and it was one of those, do I do this now and not get it or continue playing Russian roulette with cancer," said Scarf.
Discussing her double mastectomy, "people just don't get that it's an amputation, it's hard for women to get their breasts removed and on top of that, I was one of those people where something went wrong and the wound didn't heal properly."
Following the double mastectomy, an infection began around the incisions and the surgeon brought in Col. Eric D. Martin, chief of Vascular Surgery at Eisenhower Army Medical Center, to examine the incision and the surrounding area that had turned dark.
"Wound care clinics, like the one at EAMC, specialize in helping patients heal difficult wounds," said Martin.
Most wounds heal with the standard medical treatment but wounds that have been present for more than 30 days, despite standard wound care, may require more specialized treatment. The typical wounds treated by a clinic would include diabetic foot wounds, leg wounds from restricted blood flow and pressure sores.
According to Martin, "the most important thing to remember is that it is the patient that heals, not the wound. Treatment is tailored to individual medical conditions and may include a combination of education, infection control, nutritional evaluation as well as specialized wound care dressings and bioengineered skin substitutes."
With Scarf, new and innovative treatments were needed to address the infection and the skin flap necrosis caused by reduced blood flow to the tissue.
Scarf describes that each week, she went to hospital and they used stem cells to heal her incisions. Martin would clean the wound and fill it with a putty like substance made with stem cells and for the last two procedures parts of a placenta was implanted to help regrow the muscle tissue that had deteriorated.
"Everything doctor Martin and his team did for me was amazing, it was a lot of every Thursdays and the treatments were almost three hours but he pulled me through and got me to where I am today."
Scarf explains that for each treatment, Martin would open the incision and go in to clean inside, like someone was power washing a house. There was a little laser that would cut away dead tissue and then they would spray a disinfectant.
"They would mix up this paste of stem cells that they would pack inside the incision and it would stay for a week. Then they would clean and repack it again."
Martin explains that there are a few types of human tissues that are regenerative including the liver and the placenta. "These can be used to regenerate chronic wounds in patients."
The stem cell therapy that Martin uses works by stimulating the growth of new blood vessels to increase blood flow to the wound and by using the stem cells to invite healthy cells from the surrounding tissue into the wound.
"The technology to inject stem cells with other growth factor products into the wound bed has only been out for a year and a half and we are the only DoD facility to use this type of medicine to treat chronic wounds," said Martin.
"Five years ago, wounds like hers would have taken 3-4 times as long to heal and would have been referred out to another hospital."
"The nurses, and doctor Martin, and the people who assisted him in the surgery, were all just great. Doctor Martin and his team went well above and beyond what I needed."
Since both incisions have healed completely, she will now begin physical therapy to build up muscle strength because her pectoral muscle had deteriorated from the infection and the muscle had to be regrown.
"I have pretty good movement but not a 100 percent of what it should be, so it will take a little physical therapy to get those muscles to loosen up and build strength," said Scarf.
Martin states that, "in Diane's case we didn't use hyperbaric medicine but this can help treat necrosis and we have had very good results with that."
EAMC's wound care clinic includes a multi-place hyperbaric chamber where a patient can breathe 100 percent oxygen either by face masks or an oxygen hood in a compressed air chamber.
It is the only clinical hyperbaric chamber in the U.S. Army, the only multiplace chamber in the Central Savannah River Area, and can seat up to 12 patients at the same time and an attendant.
"We have treated dozens of patients, helped to save limbs, treated radiation induced necrosis following cancer surgeries, reconstructed chest walls following sternal infections, closed colocutaneous fistulas with the use of hyperbaric medicine and regenerative medicine," said Martin.
"We have developed a state of the art wound care practice at Eisenhower and I would like the community and our patients to know about it."