Using meds for alternative uses/Standards of practice

[Guest guest]

Have you tried contacting the MD and discussing other options with him? Or

contacting the company who manufactures the cream and asking them questions

about other areas of use or research?

Ellen R. Strunk, PT, MS, GCS

2245 Shelterwood Road

Birmingham, AL 35226

fax:

erstrunk@...

[Guest guest]

Here's the situation:

A resident in a nursing home has a pressure ulcer. The physician has

prescribed Regranex Gel (topical gel containing growth factor) as

part of the resident's wound care regimen and the nursing staff want

the PT's to apply the gel as part of the dressing change following WP

tx.

According to the product literature, Regranex has been FDA approved

for treatment of diabetic ulcers (wounds extending into sub-q with

adequate blood supply). There has been no published research

regarding this product's efficacy in the healing of other types of

wounds.

At this point in time, the PT staff have refused to complete the

dressing change using this product. If, however, the PT would apply

this topical agent as part of the dressing change (as outlined in the

POC established by the physician), would it be considered

unprofessional conduct? (In the state of PA, unprofessional conduct

is defined as " ...any departure from or the failure to conform to the

minimal standards of acceptable and prevailing physical therapy

practice... " )

I realize that I would need to contact the State Board and possibly

APTA for further clarification on this issue. I'm wondering what

opinions my colleagues have regarding this issue. Any thoughts?

Thanks!

Kerri Bednarcik, PT

Philadelphia, PA

[Guest guest]

At some point in the last year (or so), Ortho-McNeil (Regranex) has

halted further studies on the use of Regranex with certain wounds

(venuous and I believe pressure ulcers) due to a lack of efficacy. The

results they were acheiving were typical of those seen without the use

of a growth factor.

Call your Regranex rep - he/she should have the literature that would

help to support your position. Typically, they don't want their

products being used unless they are going to have good results.

Misty Vaughn, PT, CWS