Medical professionals define a chronic wound as one that has not started to heal in two weeks or that has not healed completely in four to six weeks. Physicians emphasize that early, advanced wound care intervention can prevent a wound from becoming an acute or chronic condition that could require serious treatment, including amputation.
You can avoid the last resort by seeking specialized care as soon as you see that a wound is not healing properly.
Specialized approaches to wound care include nutritional counseling, advanced tissue grafting, hyperbaric oxygen therapy, surgical debridement (removal of dead tissue), vascular intervention and limb compression therapy.
Successful chronic wound care often requires the involvement of physicians from several specialties and the assistance of other medical professionals. The wound care team could include specialists in primary care medicine, vascular surgery, podiatry, infectious disease, emergency medicine and plastic surgery, plus registered nurses and technicians with the training to provide a whole-body approach to healing. The team also needs to maintain communication with the patient’s primary care physician.
Wound care involves vascular assessment to evaluate the blood flow to and from the wound. If needed, a vascular surgeon can improve blood flow to the affected area using grafts and stents to detour around a blockage in circulation.
Diabetes: A wound care challenge
Some of the greatest wound care challenges involve patients who have diabetes. People with diabetes often have related conditions such as poor circulation, obesity and kidney disease. Poor circulation means the body is slower to heal wounds, and an infection that does not heal quickly can lead to gangrene or eventual amputation.
The skin of people with diabetes becomes dry and cracked, opening pathways for infection to enter the body. The hands and feet are most susceptible to infection because circulation is weakest at the extremities. Added to these threats, nerve damage, known as diabetic neuropathy, can lead to a loss of feeling in the feet and the inability to notice a foot wound or infection.
People with diabetes also have immune system problems, which increases the chance of infection. They tend to develop atherosclerosis, or clogged arteries, at a younger age than people who do not have diabetes. This further reduces blood flow to the feet, which further impairs healing.
A “watch and wait” approach with any type of wound can endanger a patient. This applies especially to people with diabetes. Developing ulcers on the feet can be life-threatening. These ulcers predict nearly a 50 percent mortality rate within five years. This mortality rate compares with that of colon cancer and is more than twice the rate of death from breast cancer and prostate cancer. In short, these types of wounds demand serious, prompt attention.
Wound care in your neighborhood
If you have a chronic wound, and especially if you have diabetes and a wound, you need to seek the care of a physician-driven wound care clinic. A wound care center can provide a more cost-effective and healthy environment in which new cells can grow, thereby speeding the healing process.
Northern Nevada Medical Center (NNMC) offers Nevada’s first physician-directed wound care clinic. The staff also treats surgical wounds, burns and wounds associated with cancer, delayed radiation injury, trauma, infectious diseases and vasculitis. They follow sophisticated wound care protocols developed by Diversified Clinical Services, the world leader in advanced wound care.
The Diversified Clinical Services practice guidelines provide the basis for pragmatic decision making. Diversified provides a proprietary clinical database drawn from care provided in more than 300 wound care centers in the United States. The NNMC Wound Care Center also features two hyperbaric oxygen therapy chambers.
The NNMC Wound Care Center is located at the Vista Medical Terrace at 2345 E. Prater Way. For more information, call 352-5353.
Todd Inman, MD, is the medical director for the Wound Care Center at Northern Nevada Medical Center. Dr. Inman practices family medicine at the Northern Nevada Medical Group. Dr. Inman earned his medical degree and completed his residency from the University of Nevada School of Medicine in Reno.