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I have dedicated over two decades to the field of wound care, actively contributing to various aspects of the medical community. During a span of more than 10 years, I played a pivotal role in conceiving, constructing, and overseeing the Wound and Hyperbaric Program at Saint Agnes Hospital. Additionally, I was integral to the planning stages of the Clovis Wound Center.
As an Assistant Professor at UCSF, I hold a significant role in training general surgery residents, fellows, and medical students. My teaching responsibilities extend to various aspects of general surgery, and I take pride in contributing to the education of the next generation of medical professionals.
My expertise lies in vascular and endovascular interventions, along with a comprehensive understanding of both superficial and deep venous diseases. Notably, I pioneered a program targeting the healing of venous ulcerations by addressing truncal reflux, contrary to the initial findings of the Eschar trial. Subsequent research, such as the Evera trial, has since validated the early treatment of truncal reflux as the standard of care in healing venous leg ulcers.
In addition to my clinical responsibilities, I have actively participated in numerous clinical trials, contributing to advancements in medical research and furthering our understanding of various conditions and treatment modalities.
My Mission Statement for Central Valley Vein and Wound Centers:
My approach to wound and vascular care aligns with the mission of Central Valley Vein and Wound Centers: to deliver comprehensive wound and vascular care services in smaller, underserved communities. The primary objective is to address wounds and vascular issues at an early, manageable stage, preventing the need for hospitalization and potential amputation.
In pursuit of this objective, we have developed a vertically integrated model that prioritizes community-based care. Patients receive thorough assessments of their wounds, basic wound care, and evaluations to determine the underlying causes. Our approach is multifaceted, encompassing the aggressive treatment of vascular diseases (both arterial and venous), addressing lifestyle factors such as diabetes control and nutrition, and considering chronic health issues like neurologic disorders and general deconditioning.
Empowering patients and their families is integral to our philosophy. We educate them on the origins of the wound, enabling them to recognize factors that may impede or complicate the healing process.
By strategically siting our centers in smaller, underserved communities, we minimize the barriers patients face in accessing care. Transportation, a major impediment for many, is mitigated, recognizing that wound care is a gradual process that may span several months. This is particularly crucial for patients residing in towns distant from hospital-based wound ands vascular programs, where weekly attendance might be impractical, especially when limited to a single family vehicle. This accessibility challenge often results in patients discontinuing wound care, only to return when their conditions have worsened, leading to infections, emergency department visits, and, unfortunately, amputations.
Our overarching goal at Central Valley Vein and Wound Centers is to prevent amputations resulting from barriers to care access. The Central Valley, unfortunately, boasts the highest amputation rate in California, comparable to figures observed in more densely populated areas. While wound care may lack the high-profile appeal of other medical fields, its significance cannot be overstated. Contrary to common perceptions, the leading cause of amputations is infection, not chronic limb ischemia or arterial disease. What often goes unnoticed is that the majority of lower extremity amputations originate as wounds. Our mission is to intervene at the earliest stage, addressing wounds when patients present at the emergency department, preventing the progression to irreversible outcomes such as amputation.