Mr WOUND

16/09/2026

Dapat ba ituloy ang linis ng sugat kahit may schedule na for dysarticulation or amputation?

Parati itong tinatanong sa akin and ang sagot ay DAPAT!

Ito ang mga dahilan;

Pigpigilan na kumalat ang infection — pag naka-infect yung wound malapit sa amputation site, pwede itong maging sepsis, o mapilitan yung surgeon na mag-amputate ng mas mataas pa sa binalak nila originally. Kung na-control mo yung infection, mas marami kang napopreserve na tissue at nananatiling intact yung surgical plan.

I-protect yung demarcation line — sa ischemic (dry gangrene) wounds, ang katawan mismo ang gumagawa ng natural boundary between dead at viable tissue. Yung mga dressings na nagpapanatili ng dry sa area ay tumutulong sa process na ito, at pinipigilan nila na ma-convert yung dry gangrene into wet gangrene, na mas delikado (may bacteria, pwedeng maging sepsis).

Pain and comfort — masakit yung exposed tissue, nerve endings, at wound beds. Yung dressings ay nakaka-reduce ng pain at nagpoprotect against mechanical trauma habang naghihintay.

I-manage yung exudate at odor — para maintain yung quality of life habang naghihintay, na minsan umaabot pa ng weeks.

I-preserve yung tissue para sa mas magandang surgical outcome — kung mas marami yung viable tissue na naka-survive hanggang sa surgery, mas malaki yung chance na mas mababa yung amputation level, at mas madali i-fit yung prosthesis sa stump.

Ito ang references;

Conte, M. S., Bradbury, A. W., Kolh, P., White, J. V., Dick, F., Fitridge, R., Mills, J. L., Ricco, J.-B., Suresh, K. R., Murad, M. H., & the GVG Writing Group. (2019). Global vascular guidelines on the management of chronic limb-threatening ischemia. European Journal of Vascular and Endovascular Surgery, 58(1), S1–S109. https://doi.org/10.1016/j.ejvs.2019.05.006

On the multi-society 2024 PAD guideline (includes wound care and infection management recommendations):

Gornik, H. L., Aronow, H. D., Goodney, P. P., Arya, S., Brewster, L. P., Byrd, L., Chandra, V., Drachman, D. E., Eaves, J. M., Ehrman, J. K., Evans, J. N., Getchius, T. S. D., Gutiérrez, J. A., Hawkins, B. M., Hess, C. N., Ho, K. J., Jones, W. S., Kim, E. S. H., Kinlay, S., … Yang, S. S. (2024). 2024 ACC/AHA/AACVPR/APMA/ABC/SCAI/SVM/SVN/SVS/SIR/VESS guideline for the management of lower extremity peripheral artery disease. Circulation, 149(24), e1313–e1410. https://doi.org/10.1161/CIR.0000000000001251

15/09/2026

Frontliners give their hands to the job. Give them something back.

FInally FDA APPROVED

15/09/2026

Resibo ng KSA Plan

Ito ang resibo na papunta ako sa KSA nun 2021 and lhat ng nandito ay wala sa plan. God move in mysterious way hehe 😇🙏

Her mother is my last patient sa Dubai and one of the hardest case that i handled both as patient kasi doctor and hindi basta doctor, clinical head ng pathology lab sa isang hospital sa dubai…ang sakit sa ulo kasi ginagawa ako dictionary at bina validate ang nababasa nya then pinapa explain why yun na lang ang gawin da sugat…and sugat wise dahil di biro ang magnitude ng damage dahil sa POST ABDOMINOPLASTY….dito ko binuo ang HYPERGRAN dressing approach na umepek sa patient na tinuturo natin ngayon 🫣

15/09/2026

13/09/2026

Before going home we passby Sadik Grand Mosque

According sa online, it is set to become the largest mosque in the Philippines and one of the largest in Southeast Asia.

Back to home base now.

12/09/2026

Pauwi na kami ni nurse Chill Duran thanks to Ciudad Medical Zamboanga NSO team headed by Sir Jan Paolo Barandino for force feeding us with tausug and local delicacy 😛🤣

11/09/2026

Thank you po 🎶🙏🤓 Day 3

11/09/2026

Fungating Wound

Isa sa mahirap na ituro sa lahat ng dressing selection module ay ang BREAST CANCER FUNGATING WOUND BED MANAGEMENT.

For the first time, luckily may nag arise na situation where all the lectures and warnings about bleeders that we discussed on the 2nd day suddenly became real. But when you created an environment that was calm and objective, everything shifted. The hands moved with a sense of professionalism and comfort that became the norm. Everyone relaxed. No fuss, no tension—just pure science and dressing-based care.

For bleeders, we stopped using dressings and secondary dressing applied a foam wrap around the site, following the normal protocol.

Hindi naiwan sa kawalan ang patient kagaya ng kababayan natin na humihiling ng dagdag na pansin sa mga ganitong episode na dinadala sila sa ER at pahid pahid lang ang nagagawa or worst naiiwan tlg kung ano ang gagawin next.

I'm happy that it happened, and somehow, this team Ciudad Medical Zamboanga nurses will be the one to help our fellow Filipinos here in Zamboanga lead the way.

Congrats 💪🙏

10/09/2026

Pasyal pasyal muna after the training, Day Two DONE!!!

10/09/2026

DAY TWO

It is critical for me that nurses first master wound 101 before advancing to advanced dressing. Education-wise, this is the proper step to do, and once understood, this will greatly contribute to the collaboration between the doctor and the nurse, avoid the wastage of resources, and allow them to see how to do wound care from basic (low-resource setting) to advanced.

This activity will help them understand the basic concept of wound healing — that even with just povidone iodine, as long as the dos and don'ts are followed plus the hacks we are teaching in frugal management, it can respond well, which is what happened to this patient who had a venous leg ulcer 25cm x 25cm.