![Page 1: Limb Preservation, Amputation service, and Wound Carepnec-seattle.org/wp-content/uploads/2019/05/1555-Goetcheus.pdf · Limb Preservation, Amputation service, and Wound Care Surgical](https://reader030.vdocuments.net/reader030/viewer/2022040313/5e08a4bfdbce92055b5defac/html5/thumbnails/1.jpg)
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
![Page 2: Limb Preservation, Amputation service, and Wound Carepnec-seattle.org/wp-content/uploads/2019/05/1555-Goetcheus.pdf · Limb Preservation, Amputation service, and Wound Care Surgical](https://reader030.vdocuments.net/reader030/viewer/2022040313/5e08a4bfdbce92055b5defac/html5/thumbnails/2.jpg)
DISCLOSUREMark Goetcheus, BSN, RN
• No relevant financial relationship reported
![Page 3: Limb Preservation, Amputation service, and Wound Carepnec-seattle.org/wp-content/uploads/2019/05/1555-Goetcheus.pdf · Limb Preservation, Amputation service, and Wound Care Surgical](https://reader030.vdocuments.net/reader030/viewer/2022040313/5e08a4bfdbce92055b5defac/html5/thumbnails/3.jpg)
Wound, Ostomy, Limb Preservation, & Amputation Services
Mark Goetcheus Holly VanceNikki OertingBrandon Ibarra
![Page 4: Limb Preservation, Amputation service, and Wound Carepnec-seattle.org/wp-content/uploads/2019/05/1555-Goetcheus.pdf · Limb Preservation, Amputation service, and Wound Care Surgical](https://reader030.vdocuments.net/reader030/viewer/2022040313/5e08a4bfdbce92055b5defac/html5/thumbnails/4.jpg)
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
![Page 5: Limb Preservation, Amputation service, and Wound Carepnec-seattle.org/wp-content/uploads/2019/05/1555-Goetcheus.pdf · Limb Preservation, Amputation service, and Wound Care Surgical](https://reader030.vdocuments.net/reader030/viewer/2022040313/5e08a4bfdbce92055b5defac/html5/thumbnails/5.jpg)
Limb Preservation, Amputation service, and Wound Care
Amputation Education
• Physical Therapy/ Occupational Therapy
• Prosthetics & Orthotics
• Rehab Psychology
• Rehab Medicine
• Amputee Support Group
![Page 6: Limb Preservation, Amputation service, and Wound Carepnec-seattle.org/wp-content/uploads/2019/05/1555-Goetcheus.pdf · Limb Preservation, Amputation service, and Wound Care Surgical](https://reader030.vdocuments.net/reader030/viewer/2022040313/5e08a4bfdbce92055b5defac/html5/thumbnails/6.jpg)
Foot care
• Nail and Callus Debridement
• Foot Care Education
![Page 7: Limb Preservation, Amputation service, and Wound Carepnec-seattle.org/wp-content/uploads/2019/05/1555-Goetcheus.pdf · Limb Preservation, Amputation service, and Wound Care Surgical](https://reader030.vdocuments.net/reader030/viewer/2022040313/5e08a4bfdbce92055b5defac/html5/thumbnails/7.jpg)
Risk of ulceration Education
Fissure subcutaneous hemorrhage Callus
Onychogryphosis (ram’s horn) interdigital spaces 2/2 maceration & friction
Onychocryptosis/ Ingrown toe nail
![Page 8: Limb Preservation, Amputation service, and Wound Carepnec-seattle.org/wp-content/uploads/2019/05/1555-Goetcheus.pdf · Limb Preservation, Amputation service, and Wound Care Surgical](https://reader030.vdocuments.net/reader030/viewer/2022040313/5e08a4bfdbce92055b5defac/html5/thumbnails/8.jpg)
Wound Care
• Dressing Plan
• Offloading
• Conservative Sharps Debridement
![Page 9: Limb Preservation, Amputation service, and Wound Carepnec-seattle.org/wp-content/uploads/2019/05/1555-Goetcheus.pdf · Limb Preservation, Amputation service, and Wound Care Surgical](https://reader030.vdocuments.net/reader030/viewer/2022040313/5e08a4bfdbce92055b5defac/html5/thumbnails/9.jpg)
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
![Page 10: Limb Preservation, Amputation service, and Wound Carepnec-seattle.org/wp-content/uploads/2019/05/1555-Goetcheus.pdf · Limb Preservation, Amputation service, and Wound Care Surgical](https://reader030.vdocuments.net/reader030/viewer/2022040313/5e08a4bfdbce92055b5defac/html5/thumbnails/10.jpg)