Encounter of tissue in wounds

Outside the classroom I currently work at Washington Vascular Specialists. This is a clinic that treats peripheral arterial disease, particularly in the legs. A person who chronically suffers from this disease experiences a lack of blood flow to the feet, causing many complications. Particularly, patients who also have diabetes are at higher risks for suffering the symptoms of this disease. This is because a diabetic patient is more susceptible to develop a wound/ulcer in the foot, which I would now consider necrosis of the tissue. This causes difficulty because the patient’s poor blood circulation impedes the wound/ulcer from healing properly. Patients with non-healing wounds in the feet come to our clinic frequently for intervention procedures. My job is to prep the patient for procedures. This includes listening to the pulses of the dorsalis pedis arteries and the posterior tibial arteries with a portable doppler machine. I have to confess, many times I have to force myself to remain composed when removing socks from patients with wounds. As I examine the foot and remove the bandage I notice the tissue necrosis of the wound/ulcer. With a foot ulcer it is very clear to see where healthy tissue is missing and whether it is infected or not. For patients with infected ulcers I usually have to put an extra linen or drape because the ulcer tends to drain. Sometimes we have patients that come with gangrenous toes where the tissue has a black/greenish color to it. This experience makes me realize how important it is to know what healthy tissue looks like in order to diagnose pathological tissues.

It is neat to make a link between the patients I encounter and my histology class.