Editor's Note: In this interview, Windy Cole, DPM discusses when CTP use is appropriate for chronic wounds and how to move these wounds down the healing cascade.

Transcript

Hi, I'm Dr. Windy Cole, I'm the Director of Wound Care Research at Kent State University College of Podiatric Medicine and I'm also the Global Medical Affairs Director for Natrox Wound Care.

How do you evaluate when the use of a skin substitute in a chronic wound is appropriate?

This is the million-dollar question, right? When to pull the trigger on advanced products. Typically, it boils down to doing a very thorough patient and wound assessment. That's key. Trying to control all of the local and systemic factors. Controlling the wound microenvironment. Doing a debridement to remove devitalized tissue. Making certain that we're controlling for any sort of bacterial contamination. So, you've got to do the right thing first. You know, for venous leg ulcer, compression, and for diabetic foot ulcer, offloading.

And if you're doing everything right and you've worked up the patient and those wounds are just not progressing, then that's when I consider using a cellular matrix-like product to help to support wound healing.

How do skin substitutes help move hard-to-heal wounds forward?

Another not so easily answered question. They work by different mechanisms, right? There's a whole host of products that are available on the market. It's not a one size fits all answer. And I think you have to, again, go back to that wound assessment and that patient assessment. What do you feel is the big hurdle to having that wound progress onto healing trajectory?

Then you have to also understand the various products that are available on the market and what their mechanism of action is. And then you try to marry the 2 together.

For instance, if I have a very inflammatory wound, say I have an atypical wound etiology like pyoderma, or even vasculitis, I find the amniotic tissue products are very helpful because they have an inherent anti-inflammatory property present in the tissue or in the product. So, they're very helpful. So that's when I marry that product.

If I have a very deep wound and I'm looking for scaffolding or support, maybe I go with an acellular dermal matrix product because that's what it provides to the wound healing environment.

So, it really just depends on what that wound needs. You're kind of like the wound whisperer. What you need. And then you find the product that would be a best match for your goals of therapy.

About the Speaker

Dr. Windy Cole, DPM holds a bachelor’s degree in biology from the University of Cincinnati and is a graduate of the Kent State University College of Podiatric Medicine. Dr. Cole practices in Northeast Ohio where she serves as Medical Director of the Wound Care Center, University Hospitals Ahuja Medical Center and as Adjunct Professor and Director of Wound Care Research at Kent State University College of Podiatric Medicine. A dedicated wound care advocate for two decades, Dr. Cole is interested in medical education, diabetic foot care, wound care, limb salvage, and clinical research. Her passion to help others has led her to humanitarian efforts, including a medical mission to Jordan in 2018 to aid Syrian refugees. Dr. Cole has published numerous articles and is in demand as a speaker both nationally and internationally.