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| Iowa Investigator - Dr. Rita Frantz |
My research focus is chronic wound healing. My work in this field, which has spanned nearly 25 years, has addressed specifically pressure ulcers and diabetic foot ulcers. The study of pressure ulcers has been two pronged: 1) evaluating the efficacy of interventions to prevent ulcers and 2) testing the efficacy on treatment modalities for healing pressure ulcers. In the area of pressure ulcer prevention, my research has explored the effects of various types of supportive bed surfaces on pressure against the skin, skin blood flow and tissue oxygenation. The aim of this work is to identify the characteristics of a supportive bed surface that provide the greatest redistribution of pressure and optimize skin blood flow and oxygenation. My research on pressure ulcer treatment has focused on the efficacy of a form of electrotherapy, specifically transcutaneous electrical stimulation (TENS) on healing of recalcitrant ulcers. These randomized controlled trials have demonstrated that the addition of TENS to conventional moist wound therapy enhanced healing as compared to those that continued to be treated with conventional moist wound treatments alone. More recently, my research has addressed the biophysical determinants of healing in diabetic foot ulcers. Specifically, the work has attempted to identify the impediments to healing of these wounds when optimal pressure relief and local wound treatment is provided. The findings from this research point to the bacterial burden of the wound as a major factor that limits the progression of healing in diabetic foot ulcers. The role of bioburden in the ultimate outcome of diabetic foot ulcers continues to be studied in collaborative research with Dr. Sue Gardner, assistant professor, UI College of Nursing. A recently funded NIH study (Dr. Sue Gardner, PI) will attempt to develop strategies to accurately identify diabetic foot ulcers that are likely to proceed to develop infection-related complications. What led to the development of interest in this topic? My interest in chronic wound healing arose during my early years in clinical practice in intensive care. I observed that patients with severe, life-threatening illness often experienced tissue injury in the form of pressure ulcers. The treatments that were used in an effort to heal these ulcers were totally lacking in scientific base and often resembled cookbook recipes. The patients endured months of painful, unpleasant wound care often with no substantive expertise in research, I was naturally attracted to this area of investigation. What impact do you predict coming from this research? The research on the efficacy of electrotherapy for healing of pressure ulcers has already had an impact on clinical practice and public policy. The findings of my studies, combined with those of other investigators, provided the needed research evidence to convince Center for Medicare and Medicaid Service (CMS) to provide clinicians reimbursement for the use of electrical stimulation in treating chronic wounds. Thus, the research has provided patients and providers access to a proven modality for treating chronic wounds, such as pressure ulcers, which are resistant to more conventional forms of therapy. How does the research integrate into education/practice/service? The findings from the research on the efficacy of electrotherapy for healing of pressure ulcers have been incorporated into national guidelines for treatment of pressure ulcers that were developed by the Agency for Healthcare Research and Quality (AHRQ), as well as clinical protocols promulgated by multiple professional health care organizations. With the impetus generated from dissemination of these national guidelines, electrotherapy has been incorporated into textbooks and other educational media used to teach about modalities to promote wound healing. Iowa Investigator Archives August 21, 2007 |
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