Limb Preservation, Amputation service, and

Wound Care

MARK GOETCHEUS, BSN, RN, CWON, CFCN, CDE

WOUND, OSTOMY, LIMB PRESERVATION, & AMPUTEE SERVICES

HARBORVIEW MEDICAL CENTER

May 25th, 2019

CONFIDENTIAL – DO NOT DISTRIBUTE

DISCLOSUREMark Goetcheus, BSN, RN

• No relevant financial relationship reported

Wound, Ostomy, Limb Preservation, & Amputation Services

Mark Goetcheus Holly VanceNikki OertingBrandon Ibarra

Limb Preservation, Amputation service, and Wound Care

Surgical Consolation

• Salvage vs amputation

• Coordination: LP surgical service

• Vascular interventions

• Wound care plan

• Imaging, labs, ABI/TBI’s

• Infection Disease

Limb Preservation, Amputation service, and Wound Care

Amputation Education

• Physical Therapy/ Occupational Therapy

• Prosthetics & Orthotics

• Rehab Psychology

• Rehab Medicine

• Amputee Support Group

Foot care

• Nail and Callus Debridement

• Foot Care Education

Risk of ulceration Education

Fissure subcutaneous hemorrhage Callus

Onychogryphosis (ram’s horn) interdigital spaces 2/2 maceration & friction

Onychocryptosis/ Ingrown toe nail

Wound Care

• Dressing Plan

• Offloading

• Conservative Sharps Debridement

Lower Extremity Amputation Clinical Pathway (Above, Through and Below Knee)

• standardize treatment

• pre-op clinic visit to 10 weeks post-

operation

• includes trauma related procedure

• Multidiscipline approach

• Patient education

Thank yougoetch@uw.edu