The Patient (Mr. DG)
- 89-year-old Veteran with a background of diabetes and on anti-platelet medication (Clopidogrel) for retinal vein occlusion
- 3 months previously had a PTSG to the scalp for a Breslow 5.4mm and Clark V malignant melanoma
- The PTSG donor site then was from the lateral right thigh
- Recurrent melanoma of the scalp developed 3 months after necessitating another PTSG, in which the PTSG donor site was from the antero- lateral thigh of the same thigh
- Both PTSGs were performed by the same plastic surgeon
- The first graft donor site took 21 days to heal given his age, being a diabetic and on anti- platelet medication
The second PTSG
- Mr. DG presented to his GP ( the author) 12 hours after the PTSG with wound bleeding and graft donor site pain
- The donor site wound showed no signs of infection; it was cleansed, and bleeding points were cauterised; anti-platelet medication was ceased for the next 3 days, and then restarted
- The patient was offered treatment with an electrical stimulation device to promote healing and for pain control
- The device used was the Wetling W200 Micro-current Stimulation (WMCS)
Wetling W200 WMCS
- The device is currently manufactured in Denmark (Europe, not WA!) and the technology employed in the device was developed by the late John Wetling (architect) in conjunction with burns and chronic wound clinics in Switzerland and Germany
- The device has TGA registration since 2013; also have medical regulatory approvals in Denmark, Sweden, Norway, Finland, Germany, Austria, Switzerland, Greece, Thailand, Singapore, Indonesia, Malaysia and South Korea
- It is Wireless!
Electrical Stimulation (ES) of wound
- Not a new thing
- Has been around for 70 years
- Confirmed by science to:
- Increase blood flow and oxygenation of wound tissues
- Promotes angiogenesis
- Stimulation of collagen synthesis
- Activates re-epithelialisation by directed keratinocytes migration
- Reduce pain and oedema
- Highest grade of evidence (Level Ia) for healing of chronic wound
Dr Ritthy Sovann
MBBS, DCH, FRACGP, DAME
Dr Ritthy Sovann is the principal physician and owner of Riverton Medical Centre in Western Australia
Patient’s wound healing
Comparison between day 1, day 7 and day 9
No further treatment were given after the 4th treatment.
Blood clot and scabs were removed at day 9
Normal healing time for PTSG donor site
For PTSG donor site, depends on patient’s age and co-morbidities is 10 to 21 days.
I am writing this as a patient of Dr Sovann who has been treating my leg from whence the graft skin was taken.
Dr Sovann asked my permission to use his new Wetling machine on my leg wound. This was a major step in the right direction, as the results have brilliant to say the least. From a patient’s point of view, the treatment is completely painless. While the treatment is in progress for some 45 minutes, one could happily sit there and dose off, or even read a book. There is virtually no sensation. If asked, you may feel a gentle flow of air through the treated area. It was’t until Dr Sovann suggested it that I could in fact, notice it.
The treatment has hastened the repair by some 6 to 10 days as you will see from the photographs.Dennis A. Gorton