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When Wounds Won't heal

A wound that just doesn’t heal can be uncomfortable, painful or even embarrassing. It may interfere with everyday mobility, a person’s ability to work and enjoy leisure time– and sometimes, it’s just plain frightening.

This article is from our quarterly newsletter – Well Aware. If you’d like an electronic copy of the full newsletter, just ask! Leave a comment on this post or send me an email at achanguris@fmh.org!

A wound that just doesn’t heal can be uncomfortable, painful or even embarrassing. It may interfere with everyday mobility, a person’s ability to work and enjoy leisure time– and sometimes, it’s just plain frightening.

Fortunately for our community, there is the FMH Center for Wound Care & Hyperbaric Medicine. This department of Frederick Memorial Hospital is staffed by healthcare professionals who specialize in treating chronic or non-healing wounds, and is equipped with state-of-the-art equipment and technology to help even the most severe wounds heal.

What causes chronic wounds?

“Circulatory diseases and conditions like diabetes can damage nerves in the feet and legs, reducing feeling and sensation,” says Shay Ward, RN, BSN, one of the FMH Center’s Certified Wound Care Specialists. “This can cause patients to either injure themselves unknowingly, or be less aware of a wound’s severity.”

In addition, a diabetic’s high blood sugar can impair white blood cell function, making wounds more susceptible to infection. A combination of these factors can lead to the development of potentially serious chronic wounds.

Defined as wounds that do not improve significantly in a month, or heal completely in two, chronic wounds—if left untreated—can grow larger and more complicated, causing significant pain, infection and– in the worse cases—lead to amputation.

Unlike some programs that follow strict protocols for treatment, care plans developed at the FMH Center for Wound Care & Hyperbaric Medicine vary widely depending on individual needs.

“Each person receives a 90-minute initial exam, which looks at medications, nutrition, living conditions and other factors that could affect healing,” says the Center’s Medical Director Dr. Ryan Kulkarni. “After the preliminary diagnosis is made, treatment options are discussed with the patient, and a care plan is implemented and closely monitored. Specialists teach patients how to examine their skin, and suggest ways to prevent new wounds from occurring. Our priority is to find out exactly why the patient is experiencing slow-healing wounds. We don’t just treat the symptoms; we investigate the root causes, and identify any barriers to healing.”

According to Dr. Kulkarni, wound care specialists have several options for treating chronic wounds. One option is to use a process called debridement, whereby unhealthy tissue that can interfere with healing is dissolved with enzymatic treatments. Because wounds won’t heal properly if they are too moist or too dry, adds Dr. Kulkarni, he and his colleagues at the Center are careful to regulate a wound’s moisture level to promote healing.

Another effective therapy for treating severe chronic or non-healing wounds is called hyperbaric oxygen therapy. During these treatments, the patient breathes 100 percent oxygen inside a see-through, pressurized chamber, increasing the number of oxygen molecules entering the blood stream. This improves circulation to the hands and feet, enabling oxygen to reach tissue that is normally not accessible to red blood cells — facilitating healing and enhancing the infection-fighting power of white blood cells.

Healing a chronic wound isn’t fast or easy, but the results of treatment can be dramatic. In some cases, amputation can be prevented, long-standing infections cured and pain eliminated.

“We have so many options available to treat chronic and non-healing wounds,” says Center Director Blair Hughes, MHS, PT, CWS. “Patients can refer themselves to the Center for care or may be referred by a physician.”

Hughes said patients shouldn’t be afraid to ask their doctor for a referral if a wound isn’t healing, even if it’s already being treated at the doctor’s office.

For example, it was a small, mildly painful spot on her leg that brought Ms. Vera-Clay Wright to the Center last spring.

“It just wouldn’t go away,” she said, “so my doctor and I decided to have it treated here. After I concluded my series of treatments at the Center, it completely disappeared. In fact, if you looked at the site today, you wouldn’t even know that something was ever there.”

“Our comprehensive approach can heal wounds that have resisted other treatments,” says Dr. Kulkarni, “and can help patients avoid serious complications, reduce incidence of recurrence, and get their lives back.”

“Our team members work closely with the patient’s primary care physician, so we know what treatment has been attempted and can take the next step,” Hughes adds. “Sometimes seeing a wound care specialist is absolutely necessary. The sooner you get treatment, the sooner you’ll heal.”

“There’s just no reason to suffer.”

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