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Wednesday, July 27, 2011 - Fearing Amputation, Retired UT Professor Turns to Methodist Wound Treatment Center

The past year has been a difficult one for Dr. Otto Schwarz and his wife, Bobbie, of Solway. The couple’s problems began without warning last year when Dr. Schwarz decided to split some wood.

“I was carrying firewood when I tripped on some steps. The Achilles tendon on my left ankle snapped,” Schwarz recalled. He underwent surgery in July 2010 to reattach the tendon. The surgery was successful, and he was soon walking and even going up and down steps.

By early fall, however, he faced a serious challenge. Approximately 2.5 inches of the 12-inch incision in his lower leg would not heal, despite traditional treatments. With the tendon exposed in the area that would not heal, Schwarz underwent a second operation to close the wound. The wound again refused to heal.

The retired University of Tennessee professor feared that his lower leg would have to be amputated.  He needed the type of advanced care that specialized wound treatment centers provide. He found that care at the Methodist Wound Treatment Center in Oak Ridge.

“If it weren’t for Dr. David Stanley and the Methodist Wound Treatment Center, I probably would have lost my leg,” Schwarz said. “He told me that if I had suffered this wound 10 years ago, I would have lost the leg. We were very fortunate to find someone with his knowledge at this time and in this place.”

A Reason for Urgency

Schwarz saw Dr. Stanley for the first time in September. He had an initial examination one morning, and was back at the center for his first treatment later that day. The reason for urgency was that tissue in Schwarz’s ankle was dying, and about four inches of the tendon were already gone.

“Tendons have marginal blood flow in a healthy state,” Dr. Stanley said. “The circulation needed to nurture and heal tendons is provided by healthy surrounding tissue. Dr. Schwarz’s tendon was infected, with minimal healthy tissue surrounding it. He desperately needed increased oxygen to the wound in order to avoid gangrene.”

Dr. Stanley began treatment with hyperbaric oxygen therapy. “A patient lies in one of our hyperbaric chambers and breathes 100 percent pressurized oxygen for approximately 90 minutes,” the doctor said. “This enables the person to dissolve more oxygen in the red blood cells and plasma. More oxygen can reach the body’s tissues and promote healing by stimulating new artery growth in the wound.”

Schwarz went to the Methodist Wound Treatment Center every morning, five days a week, until he received 30 treatments. During this time, he and his wife cleaned the wound at home every day and applied wet packs. Dr. Stanley also cleaned the wound on a regular basis. “He spent months cutting off the ends of the tendon that were dying,” Schwarz noted.

 

A Tremendous Amount of Healing

As the hyperbaric oxygen sessions came to an end just before Christmas, Dr. Stanley recommended wound vac therapy for Schwarz. “I wore a pump on my wound 24 hours a day for five weeks. During that time, there was a tremendous amount of healing,” Schwarz said. Wound vac therapy promotes tissue granulation on the cellular level and uses negative pressure to help draw the edges of the wound together.

The next step in treatment was the use of Dermagraft, which consists of cultured, living fibroblast cells that are grown from human skin cells in a laboratory. A wound care specialist implants this substance in the wound and protects the area with dressings. Patients typically undergo this procedure about once a week until the wound heals.

 “When used as a supplement to other wound treatments, Dermagraft stimulates a patient’s own skin cells, causing them to multiply and to promote healing. With improved healing, fewer amputations are necessary,” Dr. Stanley explained. Patients also benefit from the fact that there is no need to remove healthy skin from another area of the body to use in a conventional skin graft.

            “Dermagraft was astounding,” according to Schwarz. “Every week, I could see where new tissue had formed in the wound. It took about eight weeks to build the tissue. The wound closed, and Dr. Stanley thought we were done.”

            Then, one morning several weeks after the initial wound closure, Schwarz discovered a blister in the bottom of his wound. He scheduled an appointment with Dr. Stanley for the next day.

            “The top layer of tissue had come off, although the bottom layer of cells was healthy,” Schwarz said. “Down toward the base of the heel, an area of the wound had opened up, and Dr. Stanley had to remove more of my tendon. Several weeks ago, he opened up the skin from the top to allow the wound to heal from the bottom up.”

            Schwarz has made remarkable progress since becoming a patient at the Methodist Wound Treatment Center. “He was the perfect patient who followed instructions to the letter and had excellent support from his wife,” according to Dr. Stanley. “If he had neglected any aspect of the advised treatment plan, he most likely would not have healed and would have faced a very significant lifetime disability. I am so pleased that Methodist has this facility to treat patients with serious wounds.”

 

     
Thanks to the Methodist Wound Treatment Center, Otto Schwarz celebrated a very special kind of independence day – independence from a non-healing wound… independence from a wheelchair… independence from the threat of amputation. He spent this July Fourth holiday enjoying the things he loves – his wife Bobbie, his dog Serafina and his 40-foot boat, the Lorelei, which he spent five years rebuilding and hasn’t been able to launch since an injury last summer created a non-healing wound that threatened his active lifestyle.
A Normal Life

            Schwarz and his wife, Bobbie, are anxious to return to their pre-injury lifestyle.

“We lost a year of normal living,” Bobbie Schwarz commented.

“I’ve been severely restricted since having the surgery in July,” Schwarz added. “From September to January, I was in a wheelchair and wore a boot to immobilize the ankle joint. I could stand, but there was no walking. It was very difficult. I did a lot of reading, and my wife did a lot of walking. It changed our lives dramatically, but we try to have a positive attitude.”

            Schwarz is anxious to start exercising to get back in shape, and his wife looks forward to the time when he can share the responsibility of walking their dog. One activity that particularly beckons the couple is boating. After retiring, Schwarz spent five years rebuilding a 40-foot boat, and the couple enjoyed many hours cruising area waterways until his injury forced them off the water.

Thanks to the Methodist Wound Treatment Center, Dr. Schwartz celebrated his own independence day – by spending the July fourth holiday on his boat with his two favorite companions – Bobbie and their dog, Serafina.