While being academically trained in medical school, most future providers – like physicians, surgeons, nurse practitioners or physician assistants – receive little to no instruction related to managing chronic wounds.
The science of wound care therefore has to be learned by education beyond the classroom. Much of this training is done by wound care companies when providers agree to work in the wound center. In addition there are innumerable education programs, seminars, and publications devoted to the practice of wound care. Product representatives also provide education on the latest technology utilized in the resolution of these chronic wounds.
Obtaining care in a wound center is different than your doctor’s office due to the advanced training, the application of hyperbaric oxygen therapy, and the special supplies and techniques available to treat patients for the management of their wounds.
Specialized wound centers have access to the latest technology and the latest techniques when it comes to dressings and supplies, all used to focus on healing quickly and in the most efficient manner possible.
Wound centers specialize in the treatment of several types of wounds, including:
• Diabetic foot ulcers;
• Arterial wounds resulting from lack of blood flow to the leg;
• Venous ulcers due to pooling of blood in the legs;
• Non-healing surgical wounds;
• Compromised skin grafts or amputation flaps that aren’t healing well;
• Second-degree burns; and
• Pressure ulcers.
Specialized dressings are available to help treat all wound types and are more highly specific to wound type than years ago when gauze dressings were the only option. There are dressings that can absorb large amounts of drainage, instill antimicrobial silver into the wound bed, increase or decrease moisture, lessen wound pain, and can actually apply negative pressure to a wound using a vacuum device (Wound Vac) in order to close a wound from the inside out.
Skin substitutes are also incorporated in the healing of chronic wounds. There are substitutes that are made from animal cells, and others made from human cells. These products introduce live cells into the wound in order to stimulate new skin growth.
On exciting product that is in use at the Harlan ARH Wound Treatment Center is a product called Grafix, which is made from live birth Placental tissue. Once purified, it can be applied safely to Wounds directly. This product contains adult stem cells, and other factors that help bring the wound through the healing phases finally to resolution of the wound itself. This product is in essence a skin graft; however there is no donor site to care for.
Other conditions treated in our center don’t include wounds at all, such as osteomyelitis (an infection of the bone), and crushing or radiation injuries that can occur with or without a wound. These are treated in the hyperbaric chambers.
These wounds and injuries have been proven to get better with the application of 100 percent oxygen under pressure, which infuses the body with oxygen to stimulate healing factors that can help close an open wound or heal certain types of injuries as discussed earlier.
As the science and application of new products and technology continue to expand options for advanced healing of chronic wounds, the Harlan ARH Wound Treatment Center will expand the treatment options available for our clients here in the mountains.
I will be discussing these issues in person on Friday at the hospital’s Lunch-n-Learn program in the One West Conference Room. I hope to see you there at noon.
Jose Echeverria, MD, is the medical director of the ARH Wound Treatment Center in Harlan