Even then it's not over. Eighty percent of diabetic patients who undergo amputation for chronic wounds die within five years, said Garth James, director of medical projects at the Center for Biofilm Engineering at Montana State University. The stump may become infected or sores may develop on the other foot, leading to additional amputations, James said.
Poor wound healing is "a huge problem for diabetics," James said. "These types of wounds often are treated as a nuisance versus what they really are--a medical emergency."
But an undergraduate's work is already leading to different treatments for patients at the Southwest Regional Wound Care Center in Lubbock, Texas, which treats up to 100 patients a day.
"It's really neat to know that it's significant," Ellen Swogger, 21, said of her work uncovering why diabetic ulcers can be so hard to cure. Swogger, of Miles City, is a senior in chemical and biological engineering.
The work began when Dr. Randall Wolcott, who heads the wound center, contacted the MSU biofilm center. Biofilms are sticky clusters of bacteria that resist antibiotics and other treatments.
Wolcott had read about biofilms and had a strong hunch they were involved in his patients' persistent wounds. He sent tissue samples from his patients' wounds to Swogger, who analyzed them for the presence of biofilms. She found that 60 percent of the samples had biofilms in them, compared with about 6 percent of acute wounds such as cuts or blisters.
Biofilm center scientists are preparing a scientific paper on what they've learned so far, with Swogger as a co-author.
As a result of the work, Wolcott has begun treating the ulcers with specific biofilm-fighting strategies and, according to Swogger, has noticed improvement.
"He's so excited about the project," said Swogger. "He's really passionate about helping these people. It was a great inspiration to talk to him."
Now Swogger is identifying which bacteria are in the biofilms. That information may help Wolcott further refine treatment options.
James said the biofilm center wants to develop a lab model for chronic wounds and test various topical treatments.
Swogger, who spent last summer working at a BP refinery in Washington, said the experience convinced her of two things: she's not yet ready for a full time job; and she's more attracted to research than she thought.
"She's really an outstanding student," James said, adding that Swogger is proficient in using two high-tech microscopes to carefully analyze biofilm samples.
"She may be the only [biofilm center] undergraduate in that category," James said.
The former member of the MSU cross country team and pianist said she's leaning toward graduate school, perhaps in the biological sciences.
Contact: Garth James, (406) 994-2542