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Helping Hands: Read Fredrick's Story of Life-saving Infection Treatment
Date: 4/17/2015
Wound care saves limb of diabetic patient with a dangerous infection

Trenton-resident Fredrick is a devout Christian who takes great pride in extending a helpful hand in his work and his spare time. He has served on the environmental services team at RWJ Hamilton for more than 12 years. For enjoyment, he participates in church activities and volunteers at a local nursing home.

One unexpected turn of events threatened to stop Fredrick’s hand from reaching out to help. He recalls the day he bumped his right arm with what he describes as a harmless “ding.” What started out as a seemingly simple bruise quickly became a nightmare. His dominant arm became irritated, and swelled significantly. 

“My hand just blew up. I couldn’t move my fingers and it continued on up—my forearm was the size of a football,” Fredrick, who is diabetic, recalls.

Determining a Diagnosis
Soon the skin itself became sore and the pain grew intolerable. Fredrick paid a visit to RWJ Hamilton, where a CT scan revealed an abscess in the soft tissue of his forearm, extending into the muscular fascia. 

Reza Shah, DO, a board certified general surgeon, wound care specialist and fellowship-trained vascular surgeon, removed the abscess and drained the arm, but further testing revealed Fredrick had necrotizing fasciitis, or a flesh-eating bacteria.  

“This can be a very fast-moving, highly destructive bacteria,” explains Dr. Shah. “It can lead to amputation of extremities or even death, if left untreated.”

Patients with diabetes, like Fredrick, are at higher risk of acquiring infection because the disease can compromise their immune system. They are also at risk for additional problems. Serious bacterial infections can lead to kidney trauma or failure as a result of ketoacidosis, and in extremities, infection can result in amputation. 

“In Fredrick’s case, we caught this just in time. If he had waited even another day or two to be treated, this would have resulted in amputation,” Dr. Shah says.

Team Treatment
Patrick Aufiero, MD, board certified in infectious disease, also treated Fredrick with administration of intravenous antibiotics during his two-week hospital stay. 

“Typically in this kind of case, many specialists get involved to stop the progression of the disease,” says Dr. Aufiero, who notes the team approach is key to RWJ Hamilton’s commitment to multidisciplinary care.

Dr. Shah explains that RWJ Hamilton Center for Wound Healing typically uses a wound care panel of surgeons, vascular surgeons, plastic surgeons, infectious disease specialists, internists and podiatrists to ensure multi-specialty group involvement for each patient. 

Dr. Shah managed Fredrick’s surgical and post-surgical care, which included 19 hyperbaric oxygen therapy treatments, a technique to increase oxygen in the blood to help promote healing and fight infection. The center has three individual chambers where patients inhale 100 percent oxygen under specified hyperbaric therapy, making it the largest hyperbaric therapy center in Mercer County. 

Personal Care
While Fredrick was grateful for access to top-of-the-line technologies to aid in his recovery, he was most vocal about the care he received.  

“Dr. Shah is a very good doctor. He is understanding and extremely dedicated to his patients. He made me feel comfortable and the staff was very good to me,” Fredrick says. “I didn't feel too much pain, and I thank God for the way the nurses and doctors responded. I could have lost my arm.”

Many Ways to Win Against Wounds

The wound center offers other cutting edge treatments including bioengineered skin substitutes; outpatient autologous modified partial skin grafting using the Xpansion system; application of Santyl, the only FDA-approved debriding agent; and various types of extra-cellular matrix for faster wound healing. 

Patients who are anxious to return to good health can benefit from a highly personalized approach to healing difficult-to-treat, chronic wounds at the Center.