Wound Healing Center: Improving Quality of Life

  • By Lisa Amstutz
  • August 27, 2011
  • 265
                        
Teaser article: Wound Prevention is Key for At-Risk Patients “The skin is the largest organ in the body,” said Angie Howard, RN, Clinical Manager of Wooster Community Hospital’s Wound Healing Center. Unfortunately, risk factors such as diabetes, hyperglycemia, arthritis, kidney disease, obesity and smoking can affect the skin’s healing capabilities and turn seemingly minor injuries into chronic wounds. Howard said she sees many patients with diabetes. Diabetics often suffer neuropathy, or nerve damage, that causes injuries to go unnoticed. “Patients with neuropathy should check their feet every day, looking for open areas,” she said. “If you cannot easily reach your foot, put a mirror on the floor and lift your foot to look at it.” Other keys to wound prevention are keeping the feet clean and dry and wearing properly fitted shoes. Regular visits to a podiatrist are important as well. Pressure wounds are another common injury, particularly for people confined to a bed or wheelchair. “Any bony prominence, or area where a bone is close to the skin, can break down within hours,” said Howard. She recommends patients in wheelchairs shift their weight every 15-30 minutes and use a pressure-relieving cushion. It is important to seek treatment for any wound that hasn’t healed for more than thirty days; an infected surgical wound; or a sore with increasing pain, redness or swelling, foul odor, or change in color. See your regular physician or call the Wound Healing Center at 330-263-8750 to schedule an appointment. A physician’s referral is not required. Main article: Wound Healing Center: Improving Quality of Life Tim Hughes of Millersburg credits Wooster Community Hospital’s Wound Healing Center with getting him back to a normal life after he had two toes amputated due to infection. “The staff was very motivating and encouraging,” said Hughes, who underwent daily treatments in a hyperbaric oxygen chamber for about three months. “It was a big commitment, but worth it. I’m very grateful, and I highly recommend the Wound Healing Center to anyone with a wound that won’t heal.” As an outpatient service of the hospital, the Wound Healing Center provides treatment for diabetic foot ulcers, venous stasis ulcers, pressure ulcers, skin tears, post surgical incisions, radiation wounds, burns, traumatic injuries and any other wound that has not shown signs of improvement in thirty days. “Our goal is to heal wounds in sixteen weeks,” said Administrative Manager Monique Arsenault. “We’ve had great success, even healing one patient’s thirty-year-old war wound. Sometimes wounds have been with the person for a long time—it really inhibits them.” “We are improving quality of life for many of our patients,” added Clinical Manager Angie Howard, RN. The Wound Healing Center opened in 2002. Its eight physicians represent a range of specialties including vascular surgery, internal medicine, podiatry, plastic surgery and family medicine. Registered nurses case-manage with the physicians. All medical staff receive special training at the Ohio State University’s wound training center. Patients who contact the Wound Healing Center are scheduled for an initial appointment with a physician who then creates a treatment plan. The plan usually includes weekly visits and a wound healing pathway consisting of special dressings, antibiotics, wound debridement, and even surgery if necessary. “The pathways are evidence-based—it’s been proven that they work,” said Arsenault. “We follow all the research.” In some cases, the treatment plan will include hyperbaric oxygen therapy in one of the Wound Healing Center’s two hyperbaric oxygen chambers. The chambers deliver one hundred percent pure oxygen under pressure to promote wound healing by oxygenating the blood. The pressure is the equivalent of two to two-and-a-half atmospheres, or 33-50 feet below sea level. HBO technician Mary Stoll said the Center’s equipment is the largest in Ohio, and can handle up to 700 pounds. A session in the chamber is referred to as a dive, Stoll said. Diving is painless, but the pressurized oxygen causes a little pressure in the ears, much like when an airplane takes off. Although patients are completely enclosed in the chamber, most have no problem with confinement issues because the tube is clear, she said. “We do a lot of teaching ahead of time,” said Arsenault. “We can prescribe something if needed, but find that people are usually comfortable, especially after the first few times. They have a phone to communicate with the nurse, and the HBO technician is always in there.” Patients lie in the chamber for 2 ½ hours, five days a week over their course of treatment. “It’s a serious time commitment on the patient’s part,” said Howard. Televisions and radios are provided to help pass the time. Fourteen different diagnoses currently qualify for HBO therapy, including diabetic foot ulcers, ulcers of the lower extremities, acute peripheral arterial insufficiency, compromised skin grafts, osteoradionecrosis, crush injuries and gas gangrene, among others. “In time, I believe HBO will be used for more and more things,” Stoll said. “Researchers have been studying its benefits for a number of other conditions.” Osteomyelitis, or bone infection, is one of the most common wounds seen at the Center, often resulting from diabetic neuropathy, or nerve damage. Pressure wounds are another common problem, especially when a patient spends large amounts of time in a bed or wheelchair. Radiation used in cancer treatment can cause internal wounds that may also benefit from hyperbaric oxygen therapy. Howard recommends that people seek treatment for any wound that hasn’t healed for more than thirty days; an infected surgical wound; or a sore with increasing pain, redness or swelling, foul odor, or change in color. “One great thing about the Wound Healing Center is that you can refer yourself—you don’t need a physician’s order or have to see a doctor before you come here,” said Arsenault. The Center serves a large radius, with patients coming from as far away as Ashland, Millersburg and Medina. Wooster Community Hospital provides free transportation when needed. For more information on the Wound Healing Center, call 330-263-8750 or visit their website at http://www.woosterhospital.org/pages/hospitalservices/WoundHealing.aspx.


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