for
Hope
Healing
Volume 1
INSIDE
Read about Mary Wilson’s
Fight for Her Feet Inside…
Dr. Desmond Bell,
Saving Legs and
Saving Lives
Introducing
the Fight4MyFeet
Program
Diabetic Foot Ulcer:
Awareness
Education
Reduction
Issue 1
Welcome
to the first issue of Hope for Healing!
Dear Wound Care Provider,
Thank you for your interest in the new Fight4MyFeet program. Together, through
diabetic foot ulcer awareness and education we can help influence the reduction
of lower limb amputation in this country.
In the coming months, we will be releasing multiple issues of the Hope for Healing
Wound Reporter. Each issue will highlight patient stories from around the country.
We look forward to sharing these amazing stories about patients and the wound
specialists dedicated to healing their diabetic foot wounds.
In conjunction with the launch of the Hope for Healing Wound Reporter, we will
be launching various programs and tools to help improve the treatment of diabetic
foot ulcers. These tools include educational videos and training manuals.
So enjoy the first issue...
… and watch for more exciting news from Organogenesis and Fight4MyFeet.
Brian Grow
Product Manager
IN THIS ISSUE
• Saving Legs and Lives—Dr. Desmond Bell.................................................... 3
• Save a Leg, Save a Life Partners with Fight4MyFeet..................................... 4
• Meet Mary Wilson: Getting Back on Her Feet............................................... 5
• Facts about DFUs / SAL/SAL Footnotes / About Fight4MyFeet...................... 8
Meet
Mary Wilson...
Getting Back On Her Feet and Back to Living Life
You wouldn’t know it to look at her these days, but there was a time when Mrs. Mary Wilson
wasn’t so energetic and active. Like many diabetic patients, Mary suffered for months with a
diabetic foot ulcer that prohibited her from doing many of the things she loved in life, like
visiting with family, shopping and travelling.
Mary’s Fight Begins
A long-time resident of Bartow, Florida, Mrs. Wilson had two toes
amputated ten years ago, and last year a wound opened up nearby
on her foot. “I was on vacation, and when I returned home, I discovered
a blister on my right toes that just would not go away.”
Over time, the blister on her foot turned into a non-healing wound
that prohibited Mary from doing many of the things she loved.
“It was awful,” she said. “People don’t realize what it feels like
when you have that loss of freedom, where you can’t do what
you want to do.”
Her wound was open for months before she received treatment
from Dr. Jeffrey Karr at the Lakeland Regional Wound Center.
“I was just about confined to my home for almost a year. I couldn’t
go anywhere!” she recalled.
Family is a huge part of Mary’s life. With four children and 11 grandchildren, her inability to travel and see family was very hard on her.
Now with her wound healed, Mary is back to her regular life, doing
things that she loves.
Awareness • Education • Reduction
5
A Wound Specialist Fighting for
His Patients
Although wound care as a specialty might be new to many Americans,
Jeffrey Karr, DPM, ACCPPS, FAPWCA, CWS, FCCWS, has been practicing
in Polk County, Florida, for nearly 20 years as one of the original
physicians performing wound care in the county.
A board certified podiatrist with fellowship status, the majority of
Dr. Karr’s practice is focused on wound care and limb preservation.
He has concentrated his practice in the areas of high risk patients
with chronic and acute wounds.
“Originally, Mary had a sore on the outside of her foot, which required
some surgery. Her incision healed, but she ended up having a sore
from a non-healing soft tissue after surgery. The sore stayed the
same size and became a chronic wound. And Mary’s diabetes was
very well-controlled,” said Dr. Karr. He continued, “A non-healing
wound can be very difficult for a patient. They try to do the right
thing, offload, control their blood sugar and don’t smoke. Then
they come in to see the doctor, and learn that, because of a little
pressure on the wound, it doesn’t heal.”
“I’m so grateful to be back
to my regular life, my regular
lifestyle,” said Mary.
SALSAL and Dr. Karr Making a Difference
In addition to his practice, Dr. Karr is also heavily involved in the
Save A Leg, Save A Life Foundation, including serving on the board of
directors and as an officer of the board. Recently he has deepened
his commitment even further by founding a Central Florida chapter.
The Central Florida chapter of SALSAL is the organization’s secondlargest chapter (after the founding Jacksonville chapter).
“SALSAL is a great common platform to bring everyone together to
give back to the community by reducing amputation rates,” said
Dr. Karr. “Limb preservation and salvage is not an individual endeavor;
it is a team approach. We have to work together as a multidisciplinary
unit to preserve these body parts, and we believe that the team
approach is really where wound care needs to go across the U.S.”
6
Awareness • Education • Reduction
Jeffrey Karr, DPM, ACCPPS, FAPWCA, CWS, FCCWS
The Importance of Patient Education
According to Dr. Karr, oftentimes patients don’t understand that something as simple as a callus can cause problems. “On a diabetic patient,
a bruise underneath a callus can be the beginning of an ulceration.”
That’s part of why patient education is so important: reaching patients
at the grassroots level who don’t yet understand the importance of
basic foot and wound care can often stop problems before they start.
“It’s not that anyone is ignoring problems,” he said. “If your foot
doesn’t hurt or you don’t see it physically, you might not know there
is a problem. These are the types of patients and caregivers we are
trying to reach.”
“So at the community level, we’re trying to explain to people:
sometimes you need to pause, take off your shoes and socks, and
take a look. It’s the same message for family members and caregivers.
These are difficult people to reach, and I believe that SALSAL is
doing excellent work in influencing positive behavior.”
Nurses are another key group in the fight for limb preservation.
“The nurses and PAs are really on the front lines of this battle,”
he continued. “They have more interaction with the patients, and
therefore they have the greatest opportunities for catching problems
early and for education.”
Evidence-Based Wound Treatments
Dr. Karr likes to emphasize the importance of moving on to advanced
wound treatment after a wound does not heal on its own after four
weeks. “While every patient is different, I’m very strict with chronic
“I recommend anyone with a
diabetic foot ulcer to get to
a wound center immediately.
Do your research, don’t give
up. And if it’s not healing,
find someone that won’t give
up on you either,” said Mary.
wounds,” he stated. “If a wound isn’t changing sufficiently in size
after four weeks, I will switch to an advanced modality such as
Apligraf, which is one of the three FDA-approved advanced treatments (Apligraf,® Dermagraft® and Regranex,®) for diabetic foot
ulcers.” Sometimes we will also treat the patient with a combination
of an advanced therapy plus hyperbaric oxygen therapy (HBOT),
especially if it is a specific type of wound. Then we re-assess the
patient’s progress on a regular basis to make treatment decisions
moving forward.”
After early treatments failed to heal Mary’s wound, Dr. Karr suggested
that they try Apligraf, a bi-layered treatment containing collagen and
living skin cells. After the use of this advanced technology, she was
amazed at the rapid results.
“At first I was in doubt as to whether anything could help me. But
after the first treatment, it gave me great hope. I could see that my
wound was healing almost immediately! It was incredible and it
made me feel great. I stayed off my feet for a few days, like Dr. Karr
asked me, and after that I was able to walk around.”
Dr. Karr continues to emphasize the importance of offloading as part
of the wound healing process. “It is so important—for any patient
with a foot or leg wound—to follow good wound care practices like
offloading the weight from your feet,” said Dr. Karr. “In combination
with the advanced cell based product, I’m sure that Mary’s efforts to
stay off her feet made a huge difference in giving her body the time
and rest it needed to heal, and for the product to do its job.”
Mary Wins Her Fight
“It is so great to look down and see my foot healed, where there
was an open wound for months straight. I can’t describe the feeling,”
continued Mary. “And everyone at the Lakeland wound care center
was so awesome. The nurses there who took such good care of me
are a great group of ladies. We had our little moments together,
and I appreciate them all.”
These days, Mary is back to enjoying life, and currently planning
a trip to Atlanta to visit her grandchildren. “For a while, my family
wouldn’t take me anywhere, because I was under doctor’s care.
Now I’m getting ready to take the kids shopping, and I can’t wait
to get there to see them!”
“I’m so grateful to be back to my regular life, my regular lifestyle,”
said Mary. When asked for advice she would give to other patients
with wounds, Mary replied, “I recommend anyone with a diabetic
foot ulcer to get to a wound center immediately. Do your research,
don’t give up. And if it’s not healing, find someone that won’t give
up on you either.” n
Mary’s team at Lakeland Regional Wound Center (L to R): Tonia Moore, LPN;
Yocsani Feliciano, PCA; Leslie Tooke, RN; Jeffrey Karr, DPM; Laura Byrd, RN;
Ken Maroney, PD
Awareness • Education • Reduction
7
= ME
DICAL
EMERGENCY
DFUs Need Urgent
Treatment
A Diabetic Foot Ulcer (DFU) is a true medical emergency and
should be aggressively treated. Unhealed DFUs can lead to
multiple other complications including osteomyelitis, amputation,
and ultimately death.
“If a wound isn’t changing sufficiently in size after four weeks, I will
switch to an advanced modality such as Apligraf, which is one of
the three FDA-approved advanced treatments (Apligraf,® Dermagraft® and Regranex,®) for diabetic foot ulcers.”—Jeffrey Karr, DPM,
ACCPPS, FAPWCA, CWS, FCCWS
Footnotes
Welcome to “SALSAL Footnotes”! This section
of the reporter is dedicated to current SALSAL
news and notes.
Listen to SALSAL Radio
http://www.wokv.com/s/experts/sal-sal/
Save the Date—
National Meeting May 9-11, 2013
The Save A Leg, Save A Life Foundation National
Meeting will be held May 9-11, 2013.
Quick Facts About Diabetes
• 2
5% of people with diabetes will develop a
DFU in their lifetime1
The conference will take place at the Disney Beach
and Yacht Resort, in Orlando, Florida.
• 8
5% of lower limb amputations in patients with
diabetes are preceded by ulceration1
Please visit the
Save a Leg, Save a Life website at
• 47% increased mortality risk due to history of
foot ulcer alone in patients with diabetes2
Savealegsavealife.org
for more information.
About Fight4MyFeet
Welcome to the launch of the Fight4MyFeet program. Together, through
diabetic foot ulcer awareness and education we can help influence the reduction
of lower limb amputations in this country.
Fight4MyFeet (F4MF) is a value-added program sponsored by Organogenesis
Inc., focusing on optimizing wound healing for DFUs and helping to establish
appropriate wound healing protocols.
The mission of Fight4MyFeet is to raise overall awareness of the seriousness around the growing problem
of Diabetic Foot Ulcers (DFUs) in the United States and to provide education, tools, and resources to
wound centers and patient/caregivers.
References: 1. Singh N, Armstrong DG, Lipsky BA. Preventing foot ulcers in patients with diabetes. JAMA. 2005;293(2):217-228.
2. Iversen MM, Tell GS, Riise T, et al. History of foot ulcer increases mortality among individuals with diabetes: ten-year follow-up
of the Nord-Trøndelag Health Study, Norway. Diabetes Care. 2009;32(12):2193-2199.
www.organogenesis.com
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