“Dr. Shah is a very good doctor. He is understanding and extremely dedicated to his patients. He made me feel comfortable and the staff was very good to me”
Wound care saves limb of diabetic patient with a dangerous infection
Trenton-resident Fredrick is a devout Christian who takes great pride in
extending a helpful hand in his work and his spare time. He has served
on the environmental services team at RWJ Hamilton for more than 12 years.
For enjoyment, he participates in church activities and volunteers at
a local nursing home.
One unexpected turn of events threatened to stop Fredrick’s hand
from reaching out to help. He recalls the day he bumped his right arm
with what he describes as a harmless “ding.” What started
out as a seemingly simple bruise quickly became a nightmare. His dominant
arm became irritated, and swelled significantly.
“My hand just blew up. I couldn’t move my fingers and it continued
on up—my forearm was the size of a football,” Fredrick, who
is diabetic, recalls.
Determining a Diagnosis
Soon the skin itself became sore and the pain grew intolerable. Fredrick
paid a visit to RWJ Hamilton, where a CT scan revealed an abscess in the
soft tissue of his forearm, extending into the muscular fascia.
Reza Shah, DO, a board certified general surgeon, wound care specialist
and fellowship-trained vascular surgeon, removed the abscess and drained
the arm, but further testing revealed Fredrick had necrotizing fasciitis,
or a flesh-eating bacteria.
“This can be a very fast-moving, highly destructive bacteria,”
explains Dr. Shah. “It can lead to amputation of extremities or
even death, if left untreated.”
Patients with diabetes, like Fredrick, are at higher risk of acquiring
infection because the disease can compromise their immune system. They
are also at risk for additional problems. Serious bacterial infections
can lead to kidney trauma or failure as a result of ketoacidosis, and
in extremities, infection can result in amputation.
“In Fredrick’s case, we caught this just in time. If he had
waited even another day or two to be treated, this would have resulted
in amputation,” Dr. Shah says.
Team Treatment
Patrick Aufiero, MD, board certified in infectious disease, also treated
Fredrick with administration of intravenous antibiotics during his two-week
hospital stay.
“Typically in this kind of case, many specialists get involved to
stop the progression of the disease,” says Dr. Aufiero, who notes
the team approach is key to RWJ Hamilton’s commitment to multidisciplinary care.
Dr. Shah explains that RWJ Hamilton Center for Wound Healing typically
uses a wound care panel of surgeons, vascular surgeons, plastic surgeons,
infectious disease specialists, internists and podiatrists to ensure multi-specialty
group involvement for each patient.
Dr. Shah managed Fredrick’s surgical and post-surgical care, which
included 19 hyperbaric oxygen therapy treatments, a technique to increase
oxygen in the blood to help promote healing and fight infection. The center
has three individual chambers where patients inhale 100 percent oxygen
under specified hyperbaric therapy, making it the largest hyperbaric therapy
center in Mercer County.
Personal Care
While Fredrick was grateful for access to top-of-the-line technologies
to aid in his recovery, he was most vocal about the care he received.
“Dr. Shah is a very good doctor. He is understanding and extremely
dedicated to his patients. He made me feel comfortable and the staff was
very good to me,” Fredrick says. “I didn't feel too much
pain, and I thank God for the way the nurses and doctors responded. I
could have lost my arm.”
Many Ways to Win Against Wounds
The wound center offers other cutting edge treatments including bioengineered
skin substitutes; outpatient autologous modified partial skin grafting
using the Xpansion system; application of Santyl, the only FDA-approved
debriding agent; and various types of extra-cellular matrix for faster
wound healing.
Patients who are anxious to return to good health can benefit from a highly
personalized approach to healing difficult-to-treat, chronic wounds at
the Center.