Go Back

New pathway for lower extremity wound consults

15 Jan 2023

Teamwork brings order and clarity to the process

By: Sheena Harris, MD, RPVI; Salem Health Surgical Specialty Clinic - Vascular Surgery

We are excited to announce a new multidisciplinary effort -- the Preserving Extremities Program (PEP), at Salem Health.

This program pulls care team members together to help patients at risk of losing their lower extremities. A major goal is to streamline workup and management of inpatients with chronic lower extremity wounds. 

Starting care for patients with a chronic (> two weeks old) lower extremity wound can be confusing. What specialty consultant should you call first? What studies should you order before the consult?  We are hoping to simplify this process.

A crucial step in limb preservation is ensuring adequate perfusion as part of the evaluation process. We would like to make it easier for providers to order the appropriate studies in a timely manner. 

We would also like to empower bedside nurses help connect patients to care specialists, as well! 

To contact the PEP team, please consider one of the following:

  1. Call the PEP team, available via the Salem Health Switchboard (503-561-5200), Monday through Friday, 8 a.m. to 4 p.m.
  2. Enter an order for Consult to Wound Ostomy Nurse (CON0083) with PEP TEAM in the comments. Please note the extremity and area of concern.

We encourage consults for these non-urgent, chronic wounds between 8 a.m. to 4 p.m. If after hours, and if it will not adversely affect length of stay, consider placing the consult the next business day.

Providers: For consults that are after hours, urgent, complex, or for critically ill patients, please continue to consult your podiatry, TRACS, or vascular colleagues per your discretion.

The PEP team, once activated, will evaluate the wound according to an established protocol and order the appropriate vascular arterial or venous studies if clinically indicated. Vascular Surgery will then evaluate the studies, and recommendations regarding further management will proceed from there.

The standard work will be formally reviewed by the Clinical Structures Committee and posted this month. 

Please feel free to email Sheena Harris, MD with any questions or concerns — or to receive a copy of the latest draft of the standard work.