Wound Management
Doctors, Nurse Team Tackle Exploding Growth in Wounds
Who wants to review the bulging case files of 200 patients in a nursing home where care is declining? That invitation offered some years ago sounded like drudgery to some, but surgeon Matthew Finnegan, M.D., characteristically saw it as an intellectual mountain to climb
Months later his 100-page report uncovered a glaring absence of medical professionals on-site to provide care, especially for the elderly residents with non-healing wounds. That experience helped make comprehensive care for the elderly and disabled one of Dr. Finnegan's special interests.
Out of that interest grew a major wound management program run by the Our Lady of Lourdes Medical Center physician, his associates and two nurse practitioners. The program cares for patients both in the medical center and in numerous area nursing homes.
Just in time, because "wounds" are not a rare medical phenomenon but a massive problem growing exponentially in an aging population too often burdened by diabetes, obesity and poor nutrition. These patients suffer a wound of any kind and they are at high risk, Dr. Finnegan said.
"Most wound patients are not well-nourished and I call it the Fast Food Effect," he said. "Obesity and poor nutrition are off the charts."
Wound management includes trauma wounds—gunshot and chain saw wounds, for example—but the epidemic of wounds attracting surgical interest is fed by less dramatic and more challenging conditions. They include diabetic foot wounds, surgical wounds, lower extremity arterial ulcers and pressure wounds, sometimes called bed sores.
His program also treats wounds caused by burns, radiation, chemicals and other circumstances. (He formerly served as Assistant Director of the Advanced Center for the Burn & Wound Center at St. Agnes Medical Center in Philadelphia.)
Dr. Finnegan's concept—aggressive care for wound patients in all settings—materialized with a key contribution from Advanced Practice Nurses (nurse practitioners) who helped him develop the program.
"I trained these nurses to use excellent judgment and to evaluate and treat patients with the utmost respect and compassion," he said. "They have grown to be a huge part of my practice. Nurses, physical therapists, surgeons and medical sub-specialists have all played a role in developing this science of wound management."
Because surgical skills increasingly are required in wound management, Dr. Finnegan has developed a fellowship for general surgeons seeking to excel in wound management.
Healing of complex wounds is a delicate process requiring control of infection and proper cell growth, he said. "But the process can be interrupted or delayed by poor nutrition, drugs such as steroids, poor circulation, smoking, radiation treatments and inflammation."
Spinal cord patients are particularly at risk for non-healing wounds and Dr. Finnegan is a consultant to Magee Rehabilitation Hospital for spinal cord patients.
Playing a major role in the wound management program is Dr. Finnegan's associate, Brian C, Smeal, M.D. (See his approach to wound management here.)
