St. John’s Rehab trial improves wound healing


When Cameron MacDonald first noticed a small lump in his abdomen, he immediately phoned his doctor to test for cancer. Given the demands of a career in commercial real estate, this busy father of two received the results in an appropriately fast-paced fashion. “I got my [cancer] diagnosis by Blackberry,” the 56-year old says.

Despite radiation therapy in the fall of 2007, MacDonald’s lump kept growing.

“By the time I went for surgery to remove the cancer in January, it had grown to the size of a pineapple,” MacDonald recalls.

The size and depth of his surgical incision required a large skin graft on his abdomen.

MacDonald’s stay in acute care didn’t stop there: one edge of the graft didn’t heal correctly, causing a painful wound to develop.

In early March, he arrived at St. John’s Rehab Hospital to receive treatment in the hospital’s innovative oncology rehab program. Yet, there was an added benefit to his stay at St. John’s Rehab – MacDonald received leading care for his wound.

Many people who have been in a hospital for an extended time not only have to overcome their primary medical condition, they may also have to deal with painful and potentially dangerous wounds that come from traumatic injuries, surgery or pressure ulcers (commonly known as bed sores).

Managing these wounds – and the pain, scarring or infection they may cause – requires advanced, specialized techniques. This is why St. John’s Rehab has developed a pilot rehab program dedicated specifically to specialized wound care.

“My wound has shrunk considerably in the time I’ve been at St. John’s Rehab – it has gone from being the size of a tangerine down to the size of a nickel,” MacDonald proudly states. “And the staff have helped me so much. They are wonderful – really knowledgeable, friendly and gentle.”

Advanced wound care is a relatively new science, according to Dr. Morty Eisenberg, a physician and wound care consultant who spearheaded the development of the program. “Wound care is based on principles that are often far removed from traditional medical wisdom. Evidence-based research has shown the old concept of keeping wounds dry and sterile, often through the liberal use of antiseptics, does not promote healing.”

Dr. R.G. Sibbald, a world-renowned wound care expert and Professor of Medicine at the University of Toronto, recognized St. John’s Rehab’s developing knowledge expertise in wound care. He encouraged the hospital to undertake the pilot project, which involves treating complex patients who – despite expert treatment in the community setting – have longstanding chronic ulcers.

As a specialized rehabilitation centre, St. John’s Rehab is in a unique position to bridge this gap in care. The pilot program allows clinicians from across disciplines to work together to learn about best practices, develop and research treatment methods, and deliver care that helps patients progress through the healing and rehabilitation process.

“This initiative reflects our mission to rebuild lives by involving patients in individualized, holistic rehabilitation programs,” explains Dr. Eisenberg.

Since embarking on the wound care initiative earlier this year, patients throughout the hospital have benefited immensely from this added clinical expertise.

A recent study confirms that St. John’s Rehab patients are receiving quality care. In Canadian hospitals and long-term care facilities, the average rate of patients with facility-acquired pressure ulcers is about 25 per cent. Eighteen months after introducing best-practice wound care at St. John’s Rehab, the hospital’s prevalence rate for facility-acquired pressure ulcers dropped to less than 10 per cent – an incredible reduction of 36 per cent from the start of the project.

Recently, St. John’s Rehab was recognized as one of five finalists for the 2007 RL Solutions Canadian Healthcare Excellence in Quality Award, which recognizes excellence in patient safety and quality of care. The hospital was recognized for establishing best-practices in preventing and treating pressure ulcers as well as education efforts that contribute to improved patient safety and clinical outcomes.

Now, MacDonald is mere days from heading home. “Although my stay at the hospital has been wonderful, there’s no doubt that I’m excited to leave!”

Indeed, St. John’s Rehab Hospital is also excited – about the ways this pilot project will improve care and patients’ outcomes, both at St. John’s Rehab, and in the wider healthcare community.

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