Dr. Randy Wolcott

Dr. Randy Wolcott walks into a small exam room. Seated before him is an elderly, balding man with an open wound on his right foot.

"Please don't cut anything off," the man says the moment Wolcott enters, fear and desperation in his voice.

The patient's right foot is chapped to flaking. Near the little toe, is a vivid red wound. He winces as Wolcott examines it. Like most of the patients who visit the Southwest Regional Wound Care Center in Lubbock, Texas, the man is diabetic.

"I hear that plea once or twice a day," Wolcott says later of the patient. Poor circulation and a lack of feeling in the legs and feet due to nerve damage are common with diabetes. A small cut or bruise can go unnoticed, become infected and flare into a limb- or life-threatening condition in three days. These wounds are so difficult to heal that most of medicine considers them a lost cause and treats them with amputation.

"They come to us because they've been told by another physician that the only solution is to cut off their foot or leg. They're terrified. If they have diabetes in their family, they may know that an amputation is the beginning of the end. They've seen loved ones leave this world a piece at a time and they're afraid."

Nationally, an estimated 82,000 people with diabetes had lower-limb amputations in 2002, according to the Centers for Disease Control. The numbers are expected to grow with America's soaring rate of obesity -- a leading cause of diabetes.

In Wolcott's experience, the man's foot should heal and be made whole again.

Just five years ago, he thought differently. But research from Montana State University's Center for Biofilm Engineering changed his outlook and treatment. Today, Wolcott is working with the Center to seek new ways to heal chronic wounds. Their aim: to keep tens of thousands of people in the United States, and hundreds of thousands worldwide, from becoming amputees.

Sixty to 80 patients visit Wolcott's clinic daily. The patients are young and old, men and women. Some shuffle in with walkers, others ease themselves along with canes; a few roll by in wheelchairs having lost a leg or a foot. The most fortunate among them walk. Inside their shoes or under their pant legs -- or sometimes in plain sight -- are infected wounds fit for a medical textbook.

"There are fragments of tissue, soupy-wet slough, pus and liquefied tissue, exposed bone -- we see something like that at least once a week," Wolcott said. "I tell people it's like stepping on a land mine."

It's not just feet and legs either. Out-of-control bedsores on a man with quadriplegic paralysis have led to a red gully along his spine more than 6 inches long. The bone of one of his hip joints is exposed by a wound that would take four hands to cover.

Wolcott is unflappable in his assessment: "We can heal that."

Return to regular view	Text-only              Email this article	Published: 11/27/2007