Wound care is a specialty that can require a team effort involving physicians, surgeons, dieticians, technologists and others who can help heal and prevent future occurrences.
But wounds, especially those particular to diabetics, the elderly and even cancer patients, may go too long without treatment. And that can become a life-threatening oversight by the time a wound specialist gets involved.
“It can start as something simple,” said Enrique Whittwell, M.D. [1], a surgeon who is part of the team at Wound Care and Hyperbaric Medicine at South Miami Hospital [2]. “But if you don’t get it treated, it can lead to serious infection or even a loss of a limb.”
For diabetics and other patients, the threat of limb damage is real, but the physicians and specialists throughout Baptist Health South Florida who treat wounds emphasize that their recovery rates meet or beat national averages.
Across the nation, specialized wound care is growing in demand as the population becomes older, obesity creates more diabetics and more patients are undergoing radiation treatments.
“We see a lot of patients that go untreated,” said Rodney Benjamin, M.D. [3], Hyperbaric Medicine Specialist at South Miami Hospital. “Sometimes, they come here on their own and they have been suffering quite a bit. We treat them and they get their life back.”
The hyperbarics side of wound care deals more with circulatory issues and long-time tissue scarring linked to wounds that don’t heal normally. There are also cancer patients with tissue damage from radiation. And diabetics make up a large component of wound care treatment.
The hyperbaric regiment usually involves six weeks of daily, 90-minute treatments in which the patient is exposed to four times the normal amount of oxygen. The oxygen over time allows tiny blood vessels damaged by inflammation to re-establish themselves, Dr. Benjamin said.
“Hyperbarics in wound care is not high on the radar (of other health care systems),” Dr. Benjamin said. “I know patients who previously had not had the opportunity to receive this kind of treatment.”
On the non-hyperbaric side of wound care, Dr. Whittwell often cleans wounds with a local anesthetic, cutting away dead skin in an outpatient surgical setting. Diabetic ulcers are a common problem, especially in the feet.
Often, diabetic wounds require the help of nutritionists to guide the patient and help avoid future episodes.
“Sometimes, we get elderly patients with bed sores and we find out that they are not well nourished,” Dr. Whittwell said.
Commonly known as bedsores, pressure ulcers can happen to vulnerable and ill patients over an extended hospital stay.
Wound care specialists delve beyond the wound itself to evaluate the patient’s overall health. A physical exam, lab work and other diagnostic tests may be involved. Individualized wound care plans may include:
• Oxygen measurement
• Diabetic foot care
• Podiatry referrals
• Vascular referrals
• Compression therapy
• Skin care and grafting
• Infectious disease referrals
• Nutritional screening
“The idea is to create a multidisciplinary environment where complementary treatment can be done to achieve the end result,” Dr. Benjamin said. “We save lives and we also restore the quality of life to our patients.”