Nancy Burkholder

Nancy is building an airplane. While she worked on it from inside the cockpit, the plane came loose from its mooring and dumped Nancy on the pavement. “I dusted myself off. There were no broken bones or a lot of bleeding, just some surface cuts, so didn’t go to the doctor,” Nancy says. 

But a 3-inch bruise on her thigh, just above the knee, wouldn’t heal. When it started weeping fluid, Nancy wrapped it with paper towels and plastic wrap. After a few weeks with no improvement, Nancy went to NH+C’s Urgent Care in Northfield. The team there made an appointment for her with the Wound Healing Clinic. 

Turns out the bruise was worse than it looked. 

The injury was tunneling underneath the skin, digging a dangerous path towards Nancy’s knee joint. “It was a major thing,” Nancy says. 

The risk of infection could cost Nancy her leg.  

First, the Wound Healing team needed to open the wound to reach the tunneled area to clean it effectively. Nancy calls it “daylighting,” a term railroads use when blasting through a mountaintop to lay track.  

Surgeon Ellie Cohen, MD “put her fingers inside the wound and felt around, and it didn’t hurt,” Nancy recalls. “So, she cut off the dead skin right then. It had tunneled through the fat layer and you could see the muscles underneath.” 

Next, Christina Richardson, FNP, CWON set up a rigorous schedule to clean the wound and avoid infection. She also put Nancy on antibiotics and used a wound vacuum pump to pull the serous fluid (that weeping serum that’s common in surface wounds) and help the wound dry out. 

“Christina told me that if I got any fever at all, to go right to Emergency Department. I was unaware of the risk of infection, but she was very aware of the urgency of it.”  

Nancy didn’t get an infection. Still, the wound was taking a long time to heal. So “Christina suggested putting fish on it,” Nancy recalls. 

Fish skin grafts use the skin of specific types of fish to cover the wound, acting like a scaffold for the patient’s own skin to grow into the graft and then generate its own healthy new cells. Fish and human skin have similar fats, proteins and elasticity. Fish skin grafts help with faster healing, less pain, and no risk of transmitting disease like a human skin graft might. 

Within a week, Nancy’s wound had healed by half. A second fish skin treatment shrunk it even further. 

After more than four months, Nancy’s wound was healed. 

“I’ve never been through anything as intense as this was,” she says. “I felt so well-cared for. I knew they were giving me the very best treatment they could, and I knew my responsibility to keep up the care.” 

The Wound Healing team was “just super,” Nancy adds. “They told me everything about my wound, what to look out for and how to care for it in between treatments. Everyone answered all my questions and shared all their knowledge. I didn’t know anything about what we were doing, but I learned a lot.” 

Nancy resumed flying shortly after finishing treatment. “It felt great to be back,” she says. 

It took a while longer to get back to her second plane, the one she’s building. “I just wasn’t ready to get back in there. It was an emotional piece to recover from, more than a physical recovery.” 

Nancy figures that a bolt in the plane’s mooring came loose over time and caused the accident. “I put the bolt in and then didn’t pay attention to it,” she says. It was like that with her bruise, too: “You have to pay attention to the details . . . and also know what those details are to watch for.” 

Nancy’s advice on keeping an eye out for trouble: “Never take anything for granted. You learn that as a pilot because in theory the engine could quit anytime. You always have to be aware of details, and what could happen.” 

And know that your ground crew has got you covered.