The healing of wounds that won’t heal, and dealing with those who have diabetes, heart disease and other chronic diseases, was the topic of a recent interview on Talking Health on News Radio 1240 KQEN.
Host Lisa Platt interviewed Robert Barry, the director of the Center for Wound Healing at Mercy Medical Center, and Vanessa Darnell, a nurse practitioner at the clinic about how the clinic deals with hard to heal wounds.
The following is an edited version of that interview.
Lisa: How many patients has the clinic cared for in its two years?
Robert: We’ve seen 577 new patients, healed 1,037 wounds and had bout 5,400 wound care encounters.
Lisa: What are the services provided at the Wound Center?
Robert: We really look at the whole wound and try to figure out why it isn’t healing.
For treatment, we can use advanced skin substitutes like Epi Fix, dermagraph and apagraph which promote healing.
We also do total contact casting which is the gold standard for offloading for a diabetic foot ulcer. We do hyperbaric oxygen therapy, compression therapy and other modalities.
The total contact cast can be used for patients with diabetic foot ulcers. It’s like a walking shoe that allows the patient to stand and helps them do their activities of daily living. With hyperbaric oxygen therapy, we put a patient in a tube, essentially, where they breathe 100 percent oxygen for two hours, five days a week.
With compression therapy we can do a four-layer, three-layer, or two-layer compression depending on what the patient has and what he or she can tolerate.
Lisa: How does someone get referred to the Wound Center?
Robert: It’s typically through their primary care or specialty care provider. Sometimes the patient will call directly. In those instances we will call their provider to ask if it is OK to see them.
Lisa: Do all kinds of insurances cover services at Mercy’s Wound Center?
Robert: Yes, our services are covered by the same carriers as Mercy Medical Center.
Lisa: How does proper wound care help to prevent heart disease or vascular disease?
Vanessa: It’s important for people’s overall health. Delaying wound care increases infection risk to the wound, which can spread to the whole body.
Chemicals are released in the body to fight infection which triggers inflammation responses throughout the body, and that can trigger a cascade of changes that damage multiple organ systems in the body.
So it’s really important to get in and get those chronic wounds seen.
Lisa: You indicated you are diabetic wound certified, what does that mean?
Vanessa: Over 50 percent of patients that I deal with have diabetes and 15 percent of those diabetic patients with lower extremity ulcers will progress to amputation. Those patients that had amputation, it usually shortens their life span.
Being diabetic certified, I am trained in an evidence-based approach to determine how diabetes is preventing a patient’s wound from healing and using advanced modalities, along with the provider’s help, to get wounds to heal.
Lisa: Are people with diabetes or heart disease more likely to have some kind of chronic wound?
Vanessa: Heart patients are more likely to have chronic wounds and recurrence because of high blood pressure-related damage to the heart and blood vessels, which impedes blood flow.
Diabetes causes inflammation, which damages the blood vessels, also impeding flow. And because diabetics have neuropathy, they don’t notice that they have the wound or it can get worse because they can’t feel it.
Lisa: On the new diabetic medications, are those working in concert with what you’re doing in Mercy’s Wound Center?
Vanessa: Definitely. If diabetic patients use their medication, it’s going to work, along with the diet and exercise. So we work with them to get their disease under control, then their wounds heal a lot better and often don’t recur.
Lisa: What can we all do to lessen the chance of getting a wound that won’t heal?
Vanessa: If you notice a wound that is not healing, visit your primary care provider. If you’ve done that and your PCP wants to refer you to our clinic, make an appointment so we can get that wound to heal.
Other things you can do are have a healthy diet and control your weight, optimize your chronic health issues and take your medications if you have a chronic disease.
If you smoke, then quitting is the best preventive measure. Smoking negatively impacts diseases as well as wounds.
If you’re a diabetic, wearing proper shoes is important.
Being well hydrated helps because we need water to hydrate the skin.
If you do have a wound, increasing protein intake helps with wound healing. Eating food with vitamin C, A and zinc will help with wound healing and a healthy diet can prevent a chronic wound.
Robert: If you’re a diabetic, check your feet daily and have someone check the bottoms of your feet, because you could have a sore that you don’t feel, that leads to bigger problems.
Lisa: Robert, can you tell us about the success rate at Mercy’s Wound Center?
Robert: In the two years it has been open, we’ve been able to heal 93 percent of the patients who have walked through our door. We have a median of 20 treatment days to heal.