Bleeding Control with a Topical Hemostatic Agent: Chopart’s Amputation

 

Benefits of Bleeding Control with a Topical Hemostatic Agent in Wound Care – Segment 1 – Chopart’s Amputation

This is a Chopart’s amputation on a diabetic patient on dialysis who smokes and is anticoagulated.

Dialysis patients are becoming more and more frequent as the prevalence of diabetes goes up. Diabetes affects every system in the body, from head to toe, and is the number one risk factor for development of people requiring dialysis. It is also the number one risk factor for retinopathy and blindness in the developed world, heart attack, and stroke.

Diabetes affects every system in the body through the oxidative stress that occurs and includes the wound healing cascade.  

As you look at the Chopart’s amputation you see the bottom of the calcaneus there and the tissue that is exposed. A lot of bleeding occurred as it was revascularized, the patient was on anticoagulants, because I didn’t want to stop them. I also didn’t want to use a tourniquet. After putting the Omni-stat on, and once the bleeding is done, then we put a Wound VAC over the top to help encourage all the good things that a wound vac does. It’s an instance where there is significant bleeding because the patient is anticoagulated. We have the capability now to be able to put something on that works independently of the clotting cascade, doesn’t harm the tissue, works relatively quick to achieve hemostasis, and then are able to utilize other therapies to help these patients with significant morbidity and mortality.*

_{*Text has been edited for clarity}

Presented by Matthew Regulski, DPM

Dr. Matthew Regulski, DPM is a podiatric surgery specialist in Browns Mills, NJ. Dr. Regulski completed a residency at Main Line Health System – Phila, PA. He currently practices at Ocean County Foot & Ankle Surgical Associates, P.C. and is affiliated with Community Medical Center.

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