Jenna Wishnew, MD, FACS, is a board-certified general surgeon who has championed medicine for over 10 years in the North Dallas area. Her approach is to serve the community as a true health care partner, providing the latest information regarding medical advances to patients in order to make the best possible treatment decisions. Dr. Wishnew considers it an honor to improve each patient’s life, treating their conditions so they can return to living their best life.

It is this approach that helped a recent patient of hers, Betty Morris, 76, of Plano, Texas, a retired verifier of healthcare insurance. Ms. Morris lived and suffered from venous insufficiency for over twenty years resulting in a longstanding Venous Leg Ulcer (VLU) due to poor vascular circulation or as she says “wonky vein issues” until she met Dr. Wishnew.


What is a Venous LegUlcer?1

Venous leg ulcers(VLUs) are the result of chronic venous insufficiency (CVI) and venous hypertension. VLUs carry a significant financial burden, providing a taxing toll on the healthcare system. In the United States, the Medicare and commercial insurance annual cost for VLU patients averages approximately $19,000 and $13,650, respectively. This puts an estimated burden of $14.9 billion a year for US payers. VLUs may worsen with aging, obesity, and sedentary lifestyles.

Betty’s Treatment: EPIFIX®

While there are various ways to treat VLUs, advanced wound management techniques are gaining more acceptance –namely, placental-based allografts such as EPIFIX.“The primary goal in the treatment of leg ulcers is to obtain healing as soon as possible. The faster the healing, the less chance for an infection,” notes Dr. Wishnew. EPIFIXis a durable skin substitute graft with natural barrier properties that, when applied to a wound, provides a protective environment to help support wound closure. As a semi-permeable protective barrier, EPIFIX protects the wound bed to aid in the development of granulation tissue and provides a human biocompatible extracellular matrix.

“In my practice, I use EPIFIXto help support the treatment of difficult wounds as an effective tool for helping them turn the corner,” said Dr. Wishnew. “I truly believe you have to set up the wound for success. We optimized her swelling, drainage, blood flow and once the infection was treated, we were able to move her onto another similar skin substitute graft from MIMEDX called EPICORD®, which we will apply regularly until she is fully healed.”

Clinically proven, there are several recently published peer-reviewed studies comparing EPIFIX to the standard of care that have demonstrated improved rates of wound closure. This clinical evidence includes the first Level I study published on the use of placental-based allografts for the treatment of VLUs to demonstrate clinical superiority over Standard of Care (SOC) and multilayer compression therapy. The treatment group receiving EPIFIX showed closure rates of 60% at 12 weeks and 71% at 16 weeks compared to closure rates of 35% at 12 weeks and 44% at 16 weeks in patients treated with SOC alone.2

It’s also interesting to note, the Agency for Healthcare Research and Quality (AHRQ) conducted a technology assessment analyzing skin substitutes for treating chronic wounds that included multiple EPIFIX and EPICORD studies noted as having low risk-of-bias (including the study referenced above).3This important government assessment is intended to help health care decision-makers —patients and clinicians, health system leaders, and policymakers, among others —make well-informed decisions and thereby improve the quality of health care services.

In terms of how Betty is doing today, Dr. Wishnew shares, “She’s doing great!” She also adds, “Learning how to check your legs and feet is crucial so that one can find a potential problem as early as possible; inspect them every day. Slow-healing wounds like VLUs are highly susceptible to infection that can quickly spread to surrounding tissues.”

EPIFIX may be used in various clinical applications, such as Diabetic foot ulcers(DFUs); surgical or wound debridements; pressure or decubitus ulcers; patients with complex wound defects, delayed wound healing, or healing complications as a result of other comorbidities.

This article was prepared in consultation with, and with the assistance of MIMEDX Group, Inc. representatives.


About Dr. Wishnew:

She heads the General Surgery Division of Lam Vascular and Associates. Dr. Wishnew serves as the medical director of the wound care and hyperbaric center at Methodist Richardson Medical Center. She complements her wound care practice with vein and swelling management at Lam Vascular and Associates. She is also one of the leading surgeons in Enterra Gastric stimulator placement and gastroparesis management.

Dr. Wishnew maintains numerous professional memberships, including the American Medical Association, the Texas Medical Association, the American College of Surgeons, and the Dallas County Medical Society. She’s also active in the American Medical Women’s Association and serves as a representative to the American College of Surgeons North Texas Chapter, formerly as the women in surgery representative and currently as the new membership chair. Dr. Wishnew is licensed by the Texas Medical Board and accredited by the American College of Surgeons.


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