Dr. Glenn Herrmann is a board-certified plastic reconstructive and cosmetic surgeon practicing at PAM Specialty Hospital of Denver. With his expertise and insight, he and the nurse manager, Matt Ethington, designed and developed the advanced tissue closure wound care program. The hospital is Joint Commission certified for disease-specific wound care. Dr. Herrmann took the time to visit with Provider Pulse and share his thoughts with Pinnacol’s community of providers across Colorado.
Q: What types of workers’ compensation cases do well in your program?
A: Post-surgical wounds, traumatic wounds, fistulas, pressure ulcers, arterial and venous ulcers, stable burn wounds, compromised grafts and flap closures, stable necrotizing soft tissue infections, and gangrene.
We also care for patients who have been refractory to healing despite hyperbaric oxygen therapy, high-grade topical dressings, vacuum-assisted closure or surgery.
Q: Can you tell us about the components of your program that make it unique?
A: We focus on aggressive surgical management of complex wounds with innovative and cutting-edge techniques combined with a specialized, labor-intensive post-surgery program.
- Precision surgical procedures and innovative novel techniques for advanced tissue closures (ATC) at the bedside (no operating room or general anesthesia needed)
- Dedicated and highly skilled staff of wound care professionals and bedside nursing staff
- Physical medicine and rehabilitation teams to work on transfer skills, pressure management, equipment readjustment, appropriate ambulation, and activities of daily living skills and techniques
- Case management for continued recovery after discharge
Q. What can a patient expect about the length of your program and its success rate?
A: Most patients will complete the program in eight weeks as inpatients, where they will experience a curative approach to wound care with an overall success rate of about 90%.
The ATC/flap program consists of bed rest on a special air-fluidized immersive surface, and a stretching program followed by a sitting program to re-train the patient’s affected tissue to accept pressure from sitting.
Our care team includes plastic surgeons, a certified wound nurse team manager, hospitalists, infectious disease specialists (if indicated), a dietician and nutritionist, physical and occupational therapists, and case managers.
Q: At what point in their care should patients be referred to your program?
A: Although our program is able to accept a myriad of wound types, the majority of our patients have pressure wounds or surgical wounds. There are two main entry points to the program: In the first (nonsurgical), a patient is severely debilitated (not a reconstructive candidate) with a recalcitrant wound and requires specialized wound care, specialty medical teams, beds, nutrition, antibiotics, dialysis and convalescence for recuperation, in preparation for a subsequent reconstruction. The second entry point (surgical) occurs when a patient has a sore that requires attention and the patient is a surgical candidate. It is easiest for the patient if the wound has been previously debrided by a local surgeon, but this is not required. Although we often receive patients who have failed multiple other wound care modalities and treatments (possibly for weeks or years), we invite patients earlier in their care plans.
Q: How are patients evaluated for the program, and what should they expect?
A: The wound care team reviews the patient’s state of health, wound photos, smoking/drug status, previous wound interventions and surgeries, and determines the appropriate patient admissions and wound treatment. The plan of care can be preemptively created and submitted to the insurance payer for prior approval. The care transition coordinators will communicate with the patient and family to further describe the proposed treatment plan, length of stay, surgical interventions and details related to admission to PAM Specialty Hospital of Denver.