A Wound That Turned Out to be Much More Than it Seemed

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Wound Healing
judith_wound care

When retired school teacher, Judith Drude, started ringing in her New Year in 2012 she had no idea what was right around the corner. She spent her days in the company of her loving husband and enjoyed reading and staying active whenever she could. From time to time she would babysit her grandchildren and attend scheduled physical therapy classes at her local Goodwill Fitness Center, due to a spinal surgery she had two years prior. Before she even made it to February 2012, Judith’s routine came to a halt when she discovered a small spider bite sized wound on her hip.

Taking the necessary precautions, Judith visited her physician Ann Vasile, M.D., medical director, spinal cord injury rehabilitation, Long Beach Memorial, to try and figure out what had cause the wound. At first glance the wound appeared to be a pressure ulcer, which is an area of skin that breaks down when something keeps rubbing or pressing against the skin. When her sore did not heal as expected, Judith was referred to Garrett Wirth, M.D., medical director, Wound Healing Center, Long Beach Memorial.

At the Wound Healing Center, Dr. Wirth did an examination and suspected that Judith was suffering from pyoderma gangrenosum — a rare condition that causes large, painful sores (ulcers) to develop on your skin, most often on your legs. The condition is so rare that only one out of 100,000 in the population are diagnosed with it, generally women in their 40s and 50s.

Seeking confirmation of his diagnosis, Dr. Wirth sent Judith to various colleagues for examination from rheumatologists to infectious disease specialists. It was finally a dermatologist, who did a tricky culture biopsy, which had to be taken from an exact spot, that confirmed Dr. Wirth’s diagnosis.

Knowing what they were up against, the Wound Healing Center care team devised a plan to treat Judith’s wound, which was now roughly the size of a credit card. “With Judith’s wound being right above her femoral artery we knew that we would be dealing with a high-risk situation when we began to treat her,” says Dr. Wirth. “Surgery was out of the question due to Judith’s age and the location of the wound, so we came up with a plan that would give us a slow, but steady improvement rate.

Judith was treated with Protopic® ointment to treat the skin around the wound and Hydrofera Blue® wound dressing to draw out bacteria and excess fluids. In addition to her topical treatment, Judith was prescribed an oral steroid and chloroquine (a malaria drug) in order to prevent further infection.

Practicing a multi-disciplinary approach, rather than relying on any one service or therapy, the Wound Healing Center’s physicians and registered nurses prescribed Judith to undergo Hyperbaric Oxygen (HBO) therapy — a type of treatment that requires the patient to breath 100 percent oxygen at an increased pressure for a prescribed amount of time.

In order to achieve the increased pressure required for HBO therapy, patients must receive the treatment while in a pressurized environment (a hyperbaric oxygen chamber). While in the chamber, the oxygen is absorbed into the bloodstream via the lungs and carried throughout the body by the circulatory system. HBO therapy helped to treat Judith’s wound by stimulating the growth of new blood vessels and increasing the efficiency of white blood cells to kill bacteria in and around her wound.

Throughout Judith’s 44 hyperbaric oxygen therapy treatments and various doctor visits, she kept a meticulous diary of her care that helped her and her physicians stay on top of every situation. Judith’s pyoderma gangrenosum is almost gone and she is now only taking a small amount of low-dose medication to treat her wound.

“I am very thankful for the treatment that I received at the Wound Healing Center,” says Judith. “I was never limited to one kind of treatment. Dr. Wirth and his team use every resource they have to treat their cases and I knew I could always rest assured that they always had my best interest in mind.”

With a new granddaughter on the way Judith is looking forward to returning to her normal routine and revisiting her local Goodwill Fitness Center for some long overdue workouts.

Ann T. Vasile, MD
Featured physician:

Ann T. Vasile, MD

  • Physical Medicine & Rehabilitation, Physical Medicine & Rehabilitation - Pediatric
Featured physician:

Garrett A. Wirth, MD

Medical Director, Wound Healing Center at Long Beach Memorial
  • Plastic Surgery