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Hello Sheila,
First you have to ask yourself; is this a chronic wound, an acute wound, a surgical wound, etc. Once you have answered that question you have to realize that the only accurate "culture" would be by needle biopsy going deeper into the wound to find out what is truly growing. Then you have to ask why you want a culture; is there pain, erythema, edema, foul drainage, heat, etc? All wounds have a bioburden of something in them, you need to assess the clinical s/sx as well. Although some patients who are immunosuppresed may not present with s/x of infection, they may be considered to need a culture. In non-healing wounds you also have to rule out osteomyelitis. Doing cultures require a clean wound bed (proper prep). In my experience I have found that once a culture is done you have to do something about it and there is always a follow-up, usually 48-72 hours later.
Good luck
Cheryl Nichols
LVN

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I am glad to hear of your interest in this subject.E-stim has many uses such as those you've already mentioned such as pain reduction, adjunct treatment for
wound healing, relief of spasms, for muscle relaxation, for neuromuscular reeducation, etc. However, while you can be taught electrical stimulation for wounds, it is best
given by a professional who have had formal training and education (classroom and clinic) in providing electrotherapeutic
modalities. You need to be able to not just apply the e-stim to a wound but also be able to trouble shoot if there is an untoward reaction or response. Like with any treatment, there are indications and contraindications and you need to know
these, as well as understand the pathophysiology behind the each kind of wound, and the physiology of healing with
electrotherapeutic modalities. It is for these reasons, only licensed rehab professionals provide this kind of treatment. You can
get certified in the use of e-stim for wounds but this does not necessarily give you everything you need to know to be able to evaluate both patient and wound for appropriateness for e-stim, and also to properly monitor treatment responses, as well as knowing to trouble shoot, or deciding treatment parameters as well as when to continue or discontinue treatment. Standards of care and practice acts with different states mandate that only licensed physical therapists with this training and education may make an evaluation and ultimately the decision to provide e-stim for wounds, as well as supervise treatments. This is training and education provided in PT school. If interested, look up universities and colleges offering physical therapy programs.
Good luck,

Maria Carunungan, PT, DPT, GCS, CWS
 

I cant find anything on line that does not reference Irritable Bowel Syndrome, which I have not had, BUT I did get C-Diff from all the antibiotics. Could this be the cause? Or can anyone give me any info on this disorder? It's extremely painful and Keeps getting infected over and over.

I'm desperate for info
Kelly

Kelly, I know of a place in Indianapolis who may be able to give you some information regarding brown recluse spider bites. At the time, I was visiting there they had 100% complete healing with brown recluse spider bites and no I &D and no surgerys. As far as i am concerned the physical therapist was an expert in wound care. People came from other states to see him and he was top notch in E-Stim as well. You will have to see if he (James Phillips) is still there in the Physical Therapy department. St. Francis Hospital, Beech Grove, IN.Good Luck. Mary
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DEAR KELLY,
I, TOO, WAS BITTEN BY A BROWN RECLUSE SPIDER IN 7/99!! IT HAS REOPENED FOUR TIMES!! STRESS, BAD DIET, AND BUMPING SITE ARE SO BAD FOR THIS!!!! MY LAST RE-OPENING HAPPENED RIGHT AFTER THE DEATH OF MY FATHER
8/12/06. I THEN HAD A SCREEN DOOR HIT WOUND SITE AS IT FELL OFF THE HINGES!! REMEMBER THESE RULES;
DON'T BUMP IT, DON'T PICK AT PEELING SKIN, EAT SALAD AND YOGURT EVERY DAY AS TOLERATED, KEEP WOUND SITE  EVEVATED AS MUCH AS POSSIBLE, ALWAYS USE COMPRESSION TREATMENTS GIVEN BY DOCTOR, AND GET EDUCATED!!
NOBODY WANTS TO BELIEVE YOU WHEN YOU SAY A RECLUSE SPIDER HAS BITTEN YOU--NOTICE?!!! I TELL MOST PEOPLE IT HAPPENED FROM A SHARK--MORE BELIEVABLE AND PEOPLE ARE ALREADY SCARED OF SHARKS!!

TO BE 100% HONEST, WHAT HEALED ME QUICK WAS PARTICIPATING IN A WOUNDCARE STUDY AT HUP (HOSPITAL OF PENNSYLVANIA) I FOUND OUT ABOUT IT WHILE READING THE "METRO" NEWSPAPER. THE STUDY IS AN INJECTION OF GENE THERAPY TO THE WOUND'S EDGE. YOU GET PUT IN A SOFT CAST FOR 72 HOURS. REMARKABLE RESULTS FOR MY UGLY OLD WOUND!! THE NEEDLE IS SMALL--LIKE A DIABETIC'S NEEDLE. THE STUDY IS IN YEAR 8 OF10. TAKES 10 YEARS FOR FDA TO APPROVE ANYTHING!!! WHAT A WORLD OF DIFFERENCE!! I HAVE A GREATER RESPECT FOR MY WOUND AND THE DOCTOR!! ALSO, I HAVE A DEEPER FAITH IN GOD. REMEMBER--WOUNDS HURT ALOT AS THEY GET ALONG IN HEALING DUE TO NERVE REGENERATION (PARTIAL). WHEN MINE WAS AWFUL, I TOOK DILAUDID 2MG SO I COULD STAND THE PAIN OF COMPRESSION THERAPY. MY ACHILLES TENDON WAS COMPROMISED SEVERELY FROM DEATH OF TISSUE (NECROTISM).

TO THIS DAY, I THANK GOD AND MY DADDY'S SPIRIT FOR GETTING ME THROUGH THAT LAST BOUT. I STILL EAT SALAD 5X A WEEK AND YOGURT EVERYDAY. I WEAR A SHINGUARD OVER MY WOUNDSITE OVER MY COMPRESSION STOCKING FOR PROTECTION. SHINGUARD WAS FRIM SPORTING GOODS SECTION OF WAL-MART. IT HAS VELCRO, SO I USE MINE UPSIDE DOWN ON MY OUTER LEFT ANKLE. I PULLED OFF THE PADDING INSIDE SO ONLY THE PLASTIC SHELL WITH AIRHOLES REMAIN. MY DOCTORS LIKE THIS IDEA!

CHECK OUT CLINICALTRIALS.ORG FOR A HOSPITAL/DOCTOR NEAR YOU & MAY GOD BLEES YOU WITH HEALING LIKE HE DID ME!!!!!!!!!! DR. DAVID MARGOLIS------YOU ROCK!!!!!!!!!!!! HE IS MY HERO!!!!!!!!!!

SINCERELY,
J. OERTWIG WOUNDCARE SURVIVOR!!!!!!!!!!!