As “case of the week” at our clinic we have selected. Mr. AF, an 88 year old retired banker who first presented on October 14, 2013. His chief complaint was a dermal ulcer of the left lower extremity which had been present over several months. During that period he had been undergoing conventional treatment at a wound clinic, consisting of daily dressing changes, the use of topicals, analgesics and periodic surgical debridement.

Following assessment at the Meditech clinic, the patient underwent ten therapy sessions, extending from October 14, 2013 to October 25, 2013. On that date the wound appeared to be completely epithelialized (see photograph) and the patient was relatively asymptomatic.

When dealing with these lesions, aside from patient compliance, one must evaluate other factors that contribute to the outcome. These include nutrition, supplements, correlating protocols with tissue response and local therapy.

Application of Treatment

We begin treatment with the gentle application of dilute hydrogen peroxide, poured over gauze placed on the wound and in the early stages this is utilized prior to instituting laser treatment. No other therapies are required with our method, which relies largely on natural debridement as Laser Therapy progresses. In brief the tissues are never mechanically traumatized.

The patient was asked to compress the wound at night utilizing warm saline, a directive with which he complied most of the time. In addition he was encouraged to exercise the limb using flexion and extension exercises involving the knee, ankle and small joints of the foot, along with quadriceps extensions, twenty times every two hours during the course of the day. He followed this advice religiously and the significant degree of edema originally present was completely gone after the first two weeks of treatment.

The use of antibiotics and aggressive surgical debridement, used prior to his treatment at our clinic, often prevents epithelialization and the formation of granulation tissue in the wound bed. At our institution these are rigidly avoided. Our philosophy is to support and work in conjunction with the body’s natural healing proclivities and the application of Laser Therapy.

Over many years of experience gained in the treatment of these types of lesions, we have found that the optimal debridement is accomplished by Laser Therapy, hydrogen peroxide and saline. It should be emphasized that the traditional approach to wound healing applied prior to presenting at the Meditech clinic was totally unsuccessful and gradually increased the dimensions of the wound.  Undoubtedly, if this prolonged approach had been continued, amputation of the limb would have resulted.

Conclusion

This particular example of wound healing, using a technique which is both simple and effective, should be utilized in clinics that deal with these lesions, in hospitals, dermatological offices and specialized wound clinics, on a global basis. The method should also be taught in educational institutions.

From at least the theoretical perspective, all limbs can be salvaged at a fraction of the cost incurred by the conventional therapies so widely prescribed at this time.  All therapists involved in wound care, no matter what their professional designation, should adopt the Meditech Wound Healing Technology.

For additional information, please contact Fred Kahn, MD, FRCSC(C) at info@bioflexlaser.com.

At our clinic, we continue to see an inordinate number of post-arthroscopy patients that continue to exhibit symptoms frequently more severe than prior to the performance of the procedure. These include interventions that have been performed from 2 weeks to 2 years prior to presentation at our clinic.
Unquestionably, some patients derive benefit from arthroscopy, however the significant percentage of patients whose symptoms persist or become more severe following this surgical event, provides cause for reflection.
In the past six days alone, I have seen four patients who have had relatively recent arthroscopies but now complain of symptoms that have increased substantially subsequent to the procedure. In view of this, one should consider alternative modes of treatment for these patients.
At our clinics, we treat many knee problems with Laser Therapy and symptoms generally begin to diminish after the 2nd or 3rd treatment. Generally more significant change occurs after 5 treatments and almost invariably after 10-20 therapeutic sessions, patients are asymptomatic. On average, 10 treatments readily achieve a desirable result, administered over a course of 3-4 weeks.
In this article, we do not extensively explore the patient’s status pre-arthroscopy but simply the subjective and objective findings demonstrated at the time of the initial and subsequent assessments, as treatment progresses.

CONCLUSION

Prior to the performance of arthroscopic surgery, all these cases should be subjected to a mandatory course of Laser Therapy consisting of at least 10 sessions. This will determine whether the pathology, consisting of inflammation, structural damage, etc., can be resolved. In my experience by following this course, surgery would seldom be necessary. This commentary should be a stimulus for eliminating the extensive number of arthroscopic procedures routinely performed that may cause complications and even more significantly, may be unnecessary.