Connie Foot Photo #14

Last Wednesday Connie went into the Foot God's office where he applied a dermagraft.  This was something he had wanted to do several months ago, but Medicare does not pay for it.  Doctors must wait until there is a patient in need whose insurance will cover the cost and then they use the left over pieces on medicare patients.  Supposedly.

I accompanied her on that visit, but sat back and allowed the Foot God to perform without photography over his shoulder.  The dermagraft, which we had been told was the foreskin from a penis, is apparently grown in a laboratory and comes frozen. Here is the info from the website:

• Dermagraft is a cryopreserved human fibroblast-derived dermal substitute; it is composed of fibrolblasts, extracellular matrix, and a bioabsorbable scaffold.  Dermagraft is manufactured from human fibroblast cells derived from newborn foreskin tissue. During the manufacturing process, the human fibroblasts are seeded onto a bioabsorbable polyglactin mesh scaffold. The fibroblasts proliferate to fill the interstices of this scaffold and secrete human dermal collagen, matrix proteins, growth factors, and cytokines to create a three-dimensional human dermal substitute containing metabolically active, living cells. Dermagraft does not contain macrophages, lymphocytes, blood vessels, or hair follicles. Dermagraft is supplied frozen in a clear bag containing one piece of approximately 2” x 3” for a single-use application.

It looked like a piece of wet paper to me, much like the apligraf, only it wasn't sewed on to the wound.  The Foot God just placed it in the wound and covered it with bandages to hold it on.  It will either take or it won't.  No one was to touch it or look at it.  If there was any seepage then Connie was to put gauze and wrap over the top of what was already there.  And she was to STAY OFF OF THE FOOT.

She did.  She has learned to hop and to tippy-toe and gets around using her wheelchair.  Yesterday we went back for the weekly peek.

Connie:  "I want to hear that is looking wonderful.  I want to hear, "This foot is looking great.  It looks like you have been staying off of your foot all week.  It is healing nicely and coming along better then we could have ever hoped for."  That is what I want to hear.  Because if I hear something different I might loose it."
Nurse Michele:  "It looks good."
Me:  "It does.  Smaller."
Connie:  "It looks black.  What is that black stuff?"
Nurse Michele: (measuring)  "That's just dead skin.  The depth is really smaller.  Much smaller."

Enter the Foot God.

Foot God:  "Hey"  Bends over and peers at the wound.  "Looks better."
Me:  "She wants you to cheer and give her kudos for staying off her foot all week.  She wants some excitement."
Foot God: (washing his hands) "Way to go."

The Foot God cleaned off some dead skin, stuck a piece of gauze over the wound, took off his gloves and announced we would try the dermagraft again.  He then left and went into the paying  other patient's room to put on the first piece of the dermagraft.   Nurses entered and prepared the area. 

The Foot God entered and kicked me out of his chair.  Nurse Kelly entered with the dermagraft and we all studied it.

I sat down and the Foot God went through the same routine as last week, only this time he did not put as much gauze on the wound as before.  I commented on it.  He ignored me.  Nurse Kelly finished up the wrapping, made our appointment for next week's peek, and off we went....again.