Aletha Tippett MD

Content from this Writer

wound care and legal issues
May 3rd, 2018

by Aletha Tippett MD

Medical providers, and especially wound care providers, seem to always be under the looming shadow of lawsuits and legal issues. I have written about this before, but it continues to be an issue as I receive requests for legal reviews repeatedly. I have read...

Lidocaine Chemical Makeup
April 12th, 2018

by Aletha Tippett MD

Well known for its pain-relieving properties, lidocaine can help us with wound care in many other ways. It has been my go-to product for wound care for over 20 years. I always use viscous lidocaine squirted on any dressing. The viscous lidocaine is what is...

study on statins
September 27th, 2017

by Aletha Tippett MD

Oh, what a shock to see a study published on atorvastatin treatment in the adult patients at risk of diabetic foot infection in a recent issue of Wounds.1 The conclusion of this study was that taking atorvastatin for at least three months...

doctor giving patient hope
September 7th, 2017

by Aletha Tippett MD

I have written about so many things over the past years… Maybe now is a good time to announce that I am writing a book called Hear Our Cry, an autobiographical story about 20 years of wound care and limb salvage. The process has had quite an impact...

Zinc in wound healing
April 27th, 2017

by Aletha Tippett MD

Well, what a surprise to find that what you have been doing all along is really the right thing to do even though you didn’t know the reason. Always, over the years doing wound care, I applied a thick layer of zinc oxide ointment around the patient’s wound,...

Leech Therapy
March 16th, 2017

by Aletha Tippett MD

People from across the country call or email me asking about using leeches for a loved one. Usually, I tell them to try to find someone close to them to administer therapy. Often, the problem is not something a leech could help. I have written about leech...

technology-in-wound-care
February 16th, 2017

by Aletha Tippett MD

In looking at technology that helps in wound care, how many know about—and use—lasers? Cold lasers have been used by physical therapists for years, but cosmetic lasers can also be used. I have had tremendous success using laser therapy on wounds. Healing is...

arterial and vascular disease
January 12th, 2017

by Aletha Tippett MD

This week I saw a patient with terminal peripheral vascular disease (PVD). Seeing him reminded me of how often the severity of this disease is misunderstood. He had had amputation of the toes on his right foot due to gangrene

medical leech therapy
December 7th, 2016

by Aletha Tippett MD

I was recently reflecting on a past patient that I was treating for toe wounds on his right foot, trying to avoid amputation. His toes kept getting necrotic, to the point he went for a transmetatarsal amputation (TMA) by a fine surgeon.. The surgery was very...

support surface technology and pressure injury prevention
September 22nd, 2016

by Aletha Tippett MD

The idea that pressure injuries (ulcers) can be prevented through equipment or device technology is one we must challenge as clinicians. A manufacturer of support surfaces, for example, may try to tell us that their beds, technologically superior, will...

balancing choice with outcomes
June 24th, 2016

by Aletha Tippett MD

How do you know if you are making right choice for a patient? Or, how do you know if you are even making a choice? This is true in the world of...

honey treatment and wounds
May 12th, 2016

by Aletha Tippett MD

How often have you thought about using honey in a wound dressing? Never? In twenty years of wound care, honey was always something that could be used – sometimes by itself on a wound, or sometimes with other dressing material used on a wound.

dry skin and pressure ulcers
March 10th, 2016

by Aletha Tippett MD

The other day I received a phone call from a dear physician friend of mine who works tirelessly in the field of pressure support and pressure ulcer prevention. He had been talking to some older nurses who told him that "in their day" they kept their patients...

laser therapy used in the treatment of wounds
January 28th, 2016

by Aletha Tippett MD

It would be interesting to know how many people reading this blog have tried laser therapy for wound healing. I suspect not many, and that is unfortunate because laser therapy can be a wonderful adjuvant for wound healing.

Doctor meeting with nurse
October 29th, 2015

by Aletha Tippett MD

If we let the body alone, can it take care of a healing a wound? In general, yes, leaving the body alone will get you further than some procedures because the body knows what to do, such as allowing autolytic debridement. If you look at the body, it is...

Scalpels
September 10th, 2015

by Aletha Tippett MD

Typical treatment when osteomyelitis (bone infection) is discovered is to plan a surgical treatment, usually wide debridement, but up to and including...

medicinal leeches
August 4th, 2015

by Aletha Tippett MD

I have written about biotherapy in the past, primarily about maggot therapy, but today I would like to discuss leech therapy. In the U.S., leeches are used frequently by plastic surgeons to save a surgical flap that is in danger of dying. Leeches in the U.S....

stopwatch
June 25th, 2015

by Aletha Tippett MD

Wound cleansing is an interesting dilemma. What? How can that be a dilemma? Everyone knows that you cleanse a wound before dressing it. This is what has been taught for years. Wound cleansing began in the late 19th or early 20th century once the germ theory...

periphereal vascular disease
May 21st, 2015

by Aletha Tippett MD

I was recently talking to a young nursing student who told me she had had a terrible week and cried when she had to do wound care for a patient. When asked what the problem was she reported that her patient was an elderly man near death who had severe...

Maggots
March 5th, 2015

by Aletha Tippett MD

Recently I had a discussion with several other physicians and a topic that came up was why maggots were not more widely received. I was not aware that maggots were not widely received since I have used them regularly for 15 years. So, the question is, why not...

Braden Scale
February 12th, 2015

by Aletha Tippett MD

The first step pressure ulcer prevention is conducting a thorough assessment of the patient. This includes a full body examination with special attention to pressure points, looking for any color changes, pain or bogginess. The assessment also looks at the...

Aletha Tippett demonstrating Maggot Therapy
January 26th, 2015

by Aletha Tippett MD

There is lots in store for the new year, and a great many wound care conferences just chock-full of information....

grief
November 6th, 2014

by Aletha Tippett MD

The topic of grief and bereavement is near to my heart right now as I just lost my beloved therapy dog, Barney, suddenly to hemangiosarcoma after years of service. He was an important and valued part of our healing community and will be mourned for a long...

October 1st, 2014

by Aletha Tippett MD

What is Bag Balm® and why is it the subject of a wound care blog? Bag Balm is over 100 years old, invented in 1899 to treat chapped and irritated cows' udders and teats. Of course, the Bag Balm was applied by hand to the cows' udder and teats and farmers...

September 3rd, 2014

by Aletha Tippett MD

Naltrexone is an opioid antagonist originally approved by the FDA in the early 1980s for the treatment of heroin addiction. The high dose of 50mg was used, but caused people to become too sick with...

heart
August 12th, 2014

by Aletha Tippett MD

For part 1 in this series, click here.

In a previous blog I told about the heartbreak of limb salvage when one of your patients was swooped out of your care and had an amputation. The patient I...

July 16th, 2014

by Aletha Tippett MD

Many have never heard of Charcot foot, or at least don't know what it is. If you care for individuals with diabetes who have neuropathy, you almost certainly will see...

June 12th, 2014

by Aletha Tippett MD

What? How can limb salvage be heartbreaking? Isn't it great to save a leg and a life? Of course, that is all wonderful and is what keeps you going in this very difficult field. What is heartbreaking...

May 16th, 2014

by Aletha Tippett MD

Welcome, Colton Mason, to the WoundSource blog forum. I enjoyed your opening blog on cost versus price...

April 3rd, 2014

by Aletha Tippett MD

There was an inquiry a couple months ago for a blog about biotherapy. Biotherapy refers to the use of animals for treatment and therapy for humans. This is a topic of great interest to me and I hope to others. When I was...

February 10th, 2014

by Aletha Tippett MD

I recently had a patient encounter that reminded me of the difference between palliative and curative wound care. In my role as a hospice medical director with a specialty in wound...

January 21st, 2014

by Aletha Tippett MD

There has been a very interesting and disheartening development in the past two years. My practice has always had a small private wound care clinic, and we have always been busy with referrals from local physicians. But lately those referrals have evaporated...

December 17th, 2013

by Aletha Tippett MD

We are supposed to check a wound every week and measure length, width and depth. These measurements should be getting smaller if the wound is healing, and we need to see improvement within two weeks, or have to consider that we need a different dressing on...

November 7th, 2013

by Aletha Tippett MD

Understanding Pathergy and Pyoderma Gangrenosum

Pathergy is an aberration of the skin’s innate reactivity from a homeostatic reactive mode closely coupled to tissue healing to an...

October 3rd, 2013

by Aletha Tippett MD

In 1771, Luigi Galvani discovered that the muscles of a frog leg contracted when touched by a spark. This spawned the beginning of our understanding of the relationship between electricity and electrical stimulation and its effect and use on the human body....

September 3rd, 2013

by Aletha Tippett MD

Calciphylaxis involves ischemic wounds that occur almost exclusively in patients undergoing hemodialysis. It is a syndrome of vascular calcification, thrombosis and skin necrosis. It results in...

August 7th, 2013

by Aletha Tippett MD

In considering this question as to whether amputation can be palliative, let’s keep clear that these are two separate subjects that sometimes interact. It is key to always keep our goals in mind. What is the goal...

June 27th, 2013

by Aletha Tippett MD

What a wonderful time we had in Indianapolis in mid-May at the 4th Annual Palliative Wound Care Conference. 150 people from as far away as Turkey were there for two and a half days to learn and share about palliative wound care. We had two full days, Thursday...

April 26th, 2013

by Aletha Tippett MD

In reading through the recent WoundSource blog archives, I just had to write in support of Dr. Ron Sherman’s...

March 20th, 2013

by Aletha Tippett MD

The great medical pioneer, Dr. Paul Brand, was right when he said it's not about medicine, it's about mechanics. Think of the ulcers you are asked to see and treat. I hope the first...

February 20th, 2013

by Aletha Tippett MD

For over a decade now I have treated wounds in palliative care patients and non-palliative care patients. The “funny” thing is that there is no difference in how I...

January 29th, 2013

by Aletha Tippett MD

This month's blog is in response to a comment on Recognizing and Treating Wounds Caused by Pyoderma Gangrenosum:
"What is green clay? Where do you get it? What...

December 11th, 2012

by Aletha Tippett MD

If you care for wounds and have never encountered pyoderma gangrenosum, count yourself lucky. Drawing from my years of experience and the nearly 20,000 wounds I’ve cared for, pyoderma gangrenosum is the most difficult and most challenging. Fortunately it is...

December 10th, 2012

by Aletha Tippett MD

Once the individual has been thoroughly assessed for palliative care and his or her objectives and needs have been discussed, the wound care provider must determine the wound management strategy to follow. This strategy will depend upon the type of wound...

October 4th, 2012

by Aletha Tippett MD

Assessment of the individual for palliative wound care is not much different from the assessment for any wound patient. Initial questions that that should be...

September 6th, 2012

by Aletha Tippett MD

Tetanus is a multisystem disease caused by the bacterium Clostridium tetani. This bacterium is present in feces and soil. Tetanus has been mostly eradicated in the U.S. due to childhood immunization, however, there have been reported cases among...

August 9th, 2012

by Aletha Tippett MD

What steps should be taken the first time you encounter a patient with a wound? Here is my list of priorities when I assess a wound:

  1. Look at your patient—are they old and frail or young and vigorous? How easily do they move...
July 15th, 2012

by Aletha Tippett MD

Does wound care need to be expensive? In the U.S. over a billion dollars per year is spent on wound care. When dealing on an individual basis, the cost of treating a...

May 6th, 2012

by Aletha Tippett MD

Palliative wound care is a relatively new field targeting wound treatment for patients at the end of life, or patients with terminal disease or inability to tolerate standard care. The traditional goal of wound care is to heal or prepare for surgical closure...

April 9th, 2012

by Aletha Tippett MD

With a theme this month of dressings, I think it is time to give gauze its rightful due. There are a number of wound care providers who would say that “gauze has no cause”. Of course, this is said...

March 7th, 2012

by Aletha Tippett MD

Because of neuropathy, peripheral vascular disease, or age, most if not all of the patients seen for wound care have dry skin. This dry skin increases the risk of infection, skin...

February 10th, 2012

by Aletha Tippett, MD

This is a statement the cardiologist made to my patient the other day. My patient is a diabetic man with severe neuropathy, resulting in pain and...

January 10th, 2012

by Aletha Tippett MD

Biotherapy is the use of living creatures for the diagnosis or treatment of a human ailment. Creatures most commonly used include service animals (such as...

December 14th, 2011

by Aletha Tippett MD

I am often asked this common question: “how do you select the right mattress or support surface for a patient?” Despite the plethora of information on how to do this, I am going to...

November 14th, 2011

by Aletha Tippett MD

We live in an evidence-based, evidence-seeking world. We want numbers and data for everything. But in the real world we live in, day to day with our patients, what do we use for evidence?

October 18th, 2011

by Aletha Tippett MD

For a physician or nurse in wound care, the primary thing to remember is this: you are not just seeing a wound, you are seeing a person who has a wound. Do not lose sight of this human and their humanity. Always look at the whole picture of your patient, not...

September 19th, 2011

by Aletha Tippett MD

In my work with wounds, I frequently find the absence of a diagnosis of ischemia, or worse, I find a misdiagnosis. Ischemia is caused by severe obstruction of the arteries, which seriously...

August 18th, 2011

by Aletha Tippett MD

Every six minutes, somewhere in the United States, someone loses a limb due to amputation because of peripheral neuropathy. Neuropathy can cause...

July 27th, 2011

by Aletha Tippett MD

What is palliative care relative to wound treatment? In short, it is about humanity, caring and compassion. Today I saw a 90 year-old woman in a nursing home....

June 13th, 2011

by Aletha Tippett, MD

In my work as a wound physician, most of the patients I treat have diabetes because of this, much of my time is spent working with these patients to manage their diabetes.

The problems that results from their condition include: diabetic neuropathy...

April 27th, 2011

by Aletha Tippett MD

A Different Mindset

The traditional goal of wound care is to heal or prepare for surgical closure, but techniques and procedures used to “heal” a wound can be painful or uncomfortable and very costly. It is inappropriate to ignore wounds or declare...