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Time Heals All Wounds

Joseph Skurka, DPM’s extensive experience in wound care benefits patients at Saint Joseph Hospital’s Wound Care Center

LEXINGTON Have you heard the old song, “The foot bone’s connected to the shin bone, and the shin bone’s connected to the knee bone…” It is a fun way for children to learn about the human skeletal system. But that message about the connectivity of the body is a lesson that extends well beyond childhood. For wound care specialist Joseph Skurka, DPM, it is literally matter of life and death.

“I deal with a lot of patients that tend to fall through the cracks and they end up with below-theknee and above-the-knee amputations,” says Skurka, who specializes in podiatry and wound care at Saint Joseph Hospital’s Wound Care Center in Lexington. “My goal is to keep their legs on. If I keep their toe on, I keep their foot on. If I keep their foot on, I keep their leg on. If I keep their leg on, they’re going to keep walking and they’re going to stay alive.”

Skurka’s path to Saint Joseph Hospital’s Wound Care Center was a bit disjointed, but just like the human anatomy, it is all connected. He grew up in Michigan and attended Michigan State University where he studied physiology, human anatomy, and microbiology. There he heard about the WAMI (Washington Alaska Montana Idaho) Program and moved to Alaska. Through the WAMI program, people who were Alaskan residents for more than a year could apply to medical school at the University of Washington, which reserved 10 percent of the annual admissions for Alaskan residents.

While on this path to medical school, however, Skurka took a detour and got a master’s degree in education from the University of Alaska. While studying, he did a variety of odd jobs, including crab fishing and construction. Upon obtaining his degree, he taught in an Inuit village for two years, then transferred to Fairbanks, Alaska, where he taught math and science. He applied to medical school and attended Barry University in Miami, Florida, then did his residency at the VA facility in Dayton, Ohio. From there he joined Cumberland Foot and Ankle in Somerset, Kentucky, before moving to Lexington where he joined Lexington Foot and Ankle.

But why his interest in podiatry in wound care? Well, that’s all connected too. His grandfather dealt with venous stasis ulcers.

“He had been struggling with them for 10 to 15 years and ended up going to a wound care center,” says Skurka. “A podiatrist corrected his situation and that’s how I fell into podiatry.”

Wound Care Is Health Care

As a podiatrist and wound care specialist, Skurka sees many patients dealing with ulcers and other wounds much like his grandfather’s. He knows not only how painful and debilitating these wounds can be, but also how dangerous as well. “Probably 70 to 90 percent of the ulcers that I deal with, especially with vascular or systemic diseases like diabetes, are lower extremity,” says Skurka. “I diagnose some of the symptoms initially, then refer them to an interventionalist if they have vascular issues. I take care of diabetic foot ulcers and I refer them out to endocrinologists to get their blood sugar under better control.”

Skurka says that these wounds have little to do with age or gender. They are primarily related to lifestyle and non-compliance with their physician’s guidance. “It comes down to lack of adherence to what the doctors are telling them to do,” he says. “My patient population is people with COPD, peripheral artery disease, and peripheral vascular disease. If they are having an issue with their heart and their arteries, their feet are furthest away, so they may see symptoms in their toes and feet and legs before they see it in other areas.”

Poor diet, smoking, and alcoholism all contribute to the development of these conditions, which can lead to long-term antibiotics, hospital stays, neuropathy, and amputations.

“People may think wound care is easy, but it is actually very difficult, because you have to balance many variables. The patient population is difficult because of the non-compliance, so you need to be extremely patient,” says Skurka. “I create an environment that allows the body to do its job. Every patient’s environment is a little different, so you have to custom-make that environment for each patient. That includes antibiotics, watching their blood sugar, staying on top of them about smoking. Some of these people are working 16-hour days and the reason they’re not healing is, they are putting too much pressure in that area. You have to compromise with them and find a happy medium that allows them to heal as well as keep working.”

The Wound Care Center at Saint Joseph Hospital cares for patients with a variety of conditions, including acute and surgical wounds, fasciitis, diabetic and other ulcers, traumatic wounds, and radiation therapy. The specialists working in the center customize treatments for each patient.

Healing Is Part Family

Part of finding that happy medium is getting to know the patients and their families. Understanding their needs, their lifestyles, and what they want to achieve helps Skurka builds that custom-made environment and map a course to healing and long-term health.

“In most cases I’m very familiar with their family and I stay in touch with the family members,” says Skurka. “I find that the most important thing to do is to get to know each other. I explain everything in detail, in a way that they understand, so that we are all on the same page. One of the most important parts of my job is persistence. It’s being there for them and never giving up, never throwing in the towel until the patient tells me to throw in the towel.”

Skurka says that the recent introduction of cutting-edge technology enables better mapping of very small arterials and arteries, and pinpointing and repairing occlusions.

“Even the slightest improvement in a patient’s lifestyle or mindset can have a major impact. But generally, that lifestyle change doesn’t happen overnight because of one wound or one word of caution from a physician. It comes over time, with a patient, fully invested doctor there every step of the way.

“If I can change somebody’s course, I’m going to put them in a better spot,” says Skurka. “They’re probably going to keep their legs on, they’re going to stay alive longer, they’re going to be able to see their grandchildren graduate from high school and possibly get married. That’s quality of life and that’s what I shoot for. The goal is to get them out of wound care so I can run out of patients in Kentucky.” Sounds like a feat worthy of a song.