Barbara Pieper: Help for wounds that won't heal
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| Barbara Pieper |
Spending hours with former intravenous drug users, some of whom have open wounds and some whose skin is peeling away, is not the way many health professionals choose to spend their day. It’s mentally draining and there is no shortage of people who need help.
And some wounds are so severe that a stench permeates the air around the patient because, really, bacteria are just having a party on their skin.
Nursing Professor Barbara Pieper helps them all.
Pieper provides wound care in an indigent clinic in University Health Center. Although the venous ulcers in which she specializes are usually found in elderly people, a fair number of people who injected illicit drugs have developed the same type of wounds due to vein collapse, especially in their legs, feet and groin.
“This is the oldest group of former injectors we’ve ever seen; persons who injected in the 1960s and 1970s are aging,” Pieper says. “They are at risk of falls – they have chronic health problems. These people can’t move their ankles. Their mobility is affected. How can you expect people in drug treatment to do physical activity if their legs don’t work?”
Pieper, who was part of the second group of students in Wayne State’s doctoral nursing program, was hired by the university in 1980. She was teaching a class in nursing fundamentals and wanted to explore having a joint appointment in a clinic. She was offered a two-day-a-week position treating wounds at Detroit Receiving Hospital. The patients she treated had horrific injuries -- diabetic ulcers and bed sores, among other problems. Pieper learned a lot about wounds, fast.
She learned that the influx of patients in their 40s with venous leg ulcers were usually IV drug users, a topic about which she knew next to nothing. So she spent her weekends conducting research on people with drug habits.
In October 1991, she started the outpatient wound care clinic and has seen patients twice a week since. As word spread of her willingness to help some of the area’s most undesirable patients, the workload increased dramatically.
“It got unreal,” she says. “I was seeing 40-50 people per day.”
The number has diminished somewhat, although a recent Tuesday brought 38 people. Pieper attributes the drop to more wound services being offered elsewhere.
Pieper recently received a $1.1 million grant from the National Institute for Nursing Research for a study on the effect of drug use on the legs.
“Basic education is key, because right now we can’t reduce the damage in the legs,” Pieper says. “These persons have wounds life-long; the wounds can reopen even if they aren’t using (drugs) anymore. Rehab, social and work life can be hampered with this condition.
“The health care community must be more astute in assessing and getting people into treatment for this problem.”