Huron Regional Medical Center

Keeping Feet in Fine Form "Diabetes is a complex disease requiring a team approach," says Chad Stapp, DPM, podiatrist at Avera Medical Group Podiatry Aberdeen. "Comprehensive diabetic foot care requires a podiatrist and a primary care physician, as well as an endocrinologist and a nutritionist to help patients control A1C and blood sugar and a vascular surgeon to check blood flow." Diabetes complicates foot wounds by affecting the blood flow to the foot, which can in turn lead to a loss of sensation in the foot due to neuropathy. Lack of sensation causes people with diabetes to walk on their wounded foot, causing additional damage and preventing early treatment. "To improve their foot health, people with diabetes should quit smoking and drinking alcohol, eat better, and focus on being healthy," Dr. Stapp says. "If they don't, minor foot wounds can lead to ulceration and amputation." REAL Healing If wounds fail to heal following more conservative treatments, the synthetic skin substitute EpiFix ® may be beneficial to the healing process. Jack Hyde, a 91-year-old diabetic from Huron, has had a foot wound on and off for the last 10 years, complicated by a fracture of his fifth metatarsal. Surgery isn't an option for him because of vascular concerns. In May 2015, Chad Stapp, DPM, a visiting podiatrist from Avera Medical Group Podiatry in Aberdeen, referred Hyde to HRMC rehabilitation services, where the wound care staff immediately put a plan for healing in motion. Recently, EpiFix became part of Hyde's treatment plan, and since that time, his wound has steadily shown improvement. Although EpiFix isn't the first synthetic skin substitute developed for wound care, it's less expensive, more versatile and easier to use than earlier types. It looks similar to a piece of plastic wrap but is made from dehydrated human tissue. Helping the Body Heal If a wound is unresponsive to conservative treatments, including keeping pressure off and debridement, a physician may choose to place EpiFix over the wound instead of using a traditional skin graft. EpiFix provides wound tissue with proteins Chad Stapp, DPM, talks with Jack Hyde about his foot wound, which steadily showed improvement after staff at HRMC began using Epifix. normally found in amniotic tissue in order to promote healing and regenerate skin tissue. After a week, the EpiFix is absorbed into the skin, and physicians can then put a new piece in place if necessary. "EpiFix allows wounds to heal and close faster," Dr. Stapp says. "Using EpiFix, a wound's healing rate is a lot faster than continual debridement." Ideal Indications "We can't use EpiFix on a chronic wound without debridement first," Dr. Stapp adds. "Making the wound bleed helps the body understand the wound isn't chronic anymore, and the body responds better through the healing process." Starting in July, Dr. Stapp began treating Hyde's wound with EpiFix. Each time the EpiFix was applied, the size of the wound decreased by a measurable amount, and the health of the tissue improved. For more information about wound care services, visit www.huronregional.org/services/rehabilitation or call (605) 353-6253. For information about Dr. Stapp and other visiting physicians in HRMC's specialty clinic, visit www.huronregional.org/find-a-doc. Synthetic Skin, w w w. h u r o n r e g i o n a l . o r g 4 welloneconnection

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