DREXEL HILL, Pa. – If you think that pioneering medical research only comes out of big-city university hospitals or nationally recognized medical centers, then prepare to have your opinion changed.
In fact, research conducted by three female Crozer-Keystone physicians based out of Delaware County Memorial Hospital, in Drexel Hill, can radically change how doctors treat osteomyelitis – a bone infection that can result from diabetic foot wounds. The physicians – podiatrist Rhonda Cornell, D.P.M., infectious disease specialist Jackeline Iacovella, M.D., and third-year podiatry resident Sneha Patel, D.P.M. – have earned the respect and recognition of their peers and, most recently, a prestigious national award and publication in a peer-reviewed journal.
“We typically see patients who have wounds that don’t heal or keep reopening,” says Cornell, who is also a member of the Center for Wound Healing and Hyperbaric Medicine at DCMH’s physician panel. “And we are always trying to figure out why certain wounds won’t heal. This gave us the research idea. We started reviewing bone and tissue cultures in these difficult-to-heal wounds and consistently found a certain species of diphtheroids. It’s not common for diphtheroids to cause infection, and they usually do not require treatment.” Cornell’s sense that something else was going on prompted her to call in an infectious disease specialist, which is when Iacovella got involved.
“Diphtheroids are frequently isolated from culture samples and are often regarded by clinicians as contaminants and not considered harmful,” Iacovella says. “When I reviewed the specimens obtained from our patients, the common denominator was the persistent growth of diphtheroids. We proceeded to further work up these organisms. They were all identified as corynebacterium striatum. The organisms were present in the wounds as well as the abnormal bone samples, creating a chronic infection that was impeding the healing process.”
“These patients were about to lose their legs,” Cornell adds. Instead, the physicians prescribed a 6-week course of intravenous antibiotics along with a surgical procedure to resection the infected bone. As a result, the wounds healed completely within three months post-treatment. “The patients are doing great,” Cornell says.
“We concluded that clinicians may consider corynebacterium striatum as a possible cause of osteomyelitis, especially in diabetic patients with chronic non-healing wounds,” Iacovella says.
While the physicians’ research followed four patients over 6 months, they say that the results were consistent and could be repeated over and over using the same approach. Patel presented their findings at Crozer-Keystone’s annual Resident Research Day in mid-2016, and the abstract won first place. It was the first time that a podiatry research abstract took the top prize. From there, it was submitted to the American Podiatric
Medical Association’s national oral and abstract poster competition. Cornell, Iacovella and Patel were thrilled to learn that their research tied for second place in the Outstanding Poster Abstract (Resident) category.
In April 2017, the physicians’ research will be featured at the Association for the Advancement of Wound Care’s Annual Symposium on Advanced Wound Care Spring | Wound Healing Society meeting in San Diego, Calif. It also published nationally in the peer-reviewed Journal of the American Podiatric Medical Association.
For Patel, being able to work so closely with two highly respected and experienced physicians was the opportunity of a lifetime. “Both Dr. Cornell and Dr. Iacovella brought their special skills into this project,” she says. “For me, it was a chance to learn from physicians who have a lot of research experience. But, in the end, it’s all about the patients and how they healed. The message is that we can make their lives better while improving the care process. It’s life-altering.”
For more information call 610-394-4770 or visit crozerkeystone.org/Wound.
Photo Caption: Jackeline Iacovella, M.D.; Sneha Patel, D.P.M. and Rhonda Cornell, D.P.M.