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We can heal that (continued)
MSU's findings
Researchers at MSU are working hard to provide the evidence needed to convince scientists and physicians of the biofilm-chronic wound connection.
"Randy's successes indicate that at least we're having an important impact for some patients," MSU's Garth James said. "But it's anecdotal. To find convincing evidence in a scientific manner is slower and more frustrating."
Some of that work is carried out in a windowless lab on the third floor of MSU's Engineering and Physical Sciences Building where doctoral candidate Pat Secor snaps on a pair of latex gloves and handles four bullet-shaped vials. Into each vial he puts an exact amount of fluid using a needle-nosed pipette. On the counter is a slightly battered black notebook.
"That's pretty much my whole life right there," said Secor, a Bozeman native whose cellular biology thesis is on the biofilm-chronic wound connection.
The book contains months of handwritten notes Secor has made as he has investigated what bacteria live in wound tissue samples from Wolcott's patients. The evidence is compelling for a biofilm-chronic wound link: 60 percent of chronic wound tissue samples contain biofilms, compared to only 6 percent of acute wounds from the same patient group. An acute wound is one that heals in a normal time span, instead of the months or years it takes a chronic wound to heal.
Additionally, chronic wounds appear to harbor complex ecosystems of bacteria. To date, the center has found 34 aerobic bacteria (those that thrive with oxygen) living in chronic wounds and 11 anaerobic bacteria (those that thrive without oxygen).
"The number changes every week," James said. "The more we look, the more we find."
The anaerobic bacteria are of particular interest because they've been mostly overlooked.
"These are very hard bacteria to find," James said. "They're very hard to grow in a culture, and even when you're successful in growing them it can take weeks. Clinics order anaerobic cultures all the time and find nothing. But we find them when we use DNA analysis."
The center published its findings in the October issue of Wound Repair and Regeneration, an important step in convincing the science community of biofilms' importance in chronic wounds. But there is still much to be done.
"We know they're there," James said. "But the million-dollar question is how do these biofilms delay wound healing?"
Secor's work is methodical, repetitive, quiet and precise. But he's been to Wolcott's clinic. He's met patients with holes in their feet and legs, lurid red, bleeding and oozing wounds they endure for months, sometimes years.
"Getting to see the patients one-on-one gave me motivation," Secor said. "I see it as a problem with a person rather than just a plastic tube I mail off for DNA sequencing."
A whole man
The fruits of this science can be seen in the story of Jerry Montemayor, a 38-year-old school administrator in Lubbock, who stubbed his toe on the corner of his bed one morning in December 2005 and nearly lost his foot.
Initially, Montemayor ignored the bruise. A diabetic, Montemayor has poor blood circulation in his lower legs and feet. Three days later, his toe was discolored and he limped with discomfort. He went to an emergency room.
Emergency room physicians told Montemayor his foot was severely infected and he must be admitted. He spent the next 12 days in the hospital. When his infection didn't respond to treatment, Montemayor's physicians told him his foot should be amputated, or he risked losing his entire leg and possibly his life.
"First they said it would be the top of my foot, then half of my foot, then my whole foot," Montemayor said. "They kept telling me I needed to set a date and time for my amputation. Believe me, if it wasn't for the power of prayer I don't think I'd have gotten through this."
Montemayor sought a second opinion. The next day, two staff members from Wolcott's center visited.
"I'll never forget that visit," Montemayor said. "One of the girls said 'We've seen worse. We suggest you do not get this amputated. We can treat this.'"
It was Christmas Eve.
Montemayor took their advice and began nearly a year's worth of treatments at Wolcott's clinic on Christmas Day. Today, he walks on both feet.
"The clinic staff said they were going to do their best and they did," Montemayor said. "I'm blessed to be walking."
"It's hard to relive that experience in the hospital," he said. "At the time I was thinking about my personal life. I was thinking how this would affect me meeting someone, or having a relationship with someone. Is she going to accept and support me? Is she going to be able ?to walk next to me and accept that I have a prosthetic limb?
"I was thinking 'If I have kids will I be able to run and play with them?'" Montemayor said. "I was thinking 'Am I going to be a whole man?'"
For more information on We can heal that, check out our Web Exclusives.
Learn more about the Dr. Randy Wolcott's clinic at www.woundcarecenter.net
Learn more about Montana State University's Center for Biofilm Engineering at www.erc.montana.edu
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