Paul Vetsch wants to keep his feet.
The 61-year-old retired Marine sergeant and letter carrier from Burnsville was admitted to Hennepin County Medical Center on Valentine’s Day with severe hot-water scalding on the lower halves of both his feet. After days of aggressive treatment, Vetsch had a dye injected into his blood and a diagnostic laser-light shined on his feet to see if doctors had re-established circulation beneath the skin.
“So, your toes look better,” Dr. Tom Masters explained as an image of Vetsch’s foot filled a computer screen near his hospital bed. The image glowed brightly near the toes, but stayed darker mid-foot. “This area here, I’m still worried about. … But I think we’re headed in the right direction.”
“Yep, I do, too,” Vetsch said, looking at the fresh image of his foot on the screen.
Vetsch is one of the first people in the state to try a machine called the Luna fluorescence angiography system, which uses a special dye and near-infared laser light to map “microcirculation” in the capillaries a few millimeters below the skin.
Such blood flow is critical to healing stubborn wounds, particularly for people who have radiation treatments for cancer and for diabetic patients like Vetsch, whose injuries are slower to heal because of their underlying condition. Without adequate blood flow, doctors may start to consider options like skin grafts, vascular surgery or limb removal.
“Our goal is to return him to function, pre-burn,” Steve Omodt said after debriding Vetsch’s wounds. “This is a highly motivated man who has a long life in front of him, and if we can help save his feet — he wants those feet so he can have function, and have happiness.”
HCMC is the first hospital in Minnesota to use one of the $250,000 Luna diagnostic machines made by Toronto-based Novadaq Technologies. The machine helps assess which patients might benefit from the most aggressive (and costly) therapies, and whether those techniques are working well enough to continue them.
“This particular technology will tell you whether what you are doing is working, or if it can be suspended so you can move on to a new therapy,” said North Carolina plastic surgeon Dr. Michael Zenn, the chief medical officer at Novadaq. “It’s prognostic and diagnostic.”
The direct feedback also helps keep patients engaged in their own chronic-wound care, which can be painful and depressing over long periods of time, Zenn said.
In addition to wound debridement, Vetsch underwent five days of treatments in HCMC’s hyperbaric oxygen chamber, which is an intensive therapy that is supposed to supercharge the body with oxygen to promote healing and fight infection.
The treatment works for some wounds, but not all. After seeing a week’s results depicted on the Luna machine, Vetsch agreed to keep going with it.
“It makes a person feel a lot better, when you see something like that,” he said. “It makes me feel that there is more hope for me to keep my feet, you know? Because I don’t want to lose my feet or my toes.”