Wound Care and Ulcers
Diabetic Wounds
Diabetes is a disease that affects every organ system. It can affect circulation, the nerves and skin. Diabetics are at an increased risk for skin breakdown and ulceration. Even small wounds can become a serious health issue. Increased blood sugar or glucose can inhibit healing, the immune system and cause a disruption in the normal pathway to healing. Combating this can be very difficult. Regular skin checks of the back, legs, feet and other hard to see places are very important.
One method of prevention is through diabetic shoes. Diabetic shoes (which are commonly covered by many insurance plans) are another way of protecting from ulcers and skin irritation. A diabetic risk assessment can help prevent issues in the future.
Pressure Ulcers
The most common cause of pressure ulcerations is a long-term pressure to a prominent area. This may not always be painful. the heels hips and shoulders are the most common places to get a pressure injury. Constant pressure causes damage to the skin by decreasing blood flow through the small microscopic blood vessels called capillaries. Poor nutrition, blood pressure, and moisture can contribute to pressure ulcers. Changing position frequently and relieving pressure with padding are very important. Red marks and blisters are often the earliest indicators to a very serious problem.
Infections
Infections of the skin, fascia, tendons, or bone are some of the most serious complications of a wound. The skin acts as a very important barrier to bacteria and other pathogens. When a wound or ulceration is present, there is now an opening which allows the bacteria to enter the body. When bacteria start to infect the skin the body’s immune system will attack and fight off the infection. People who have other illnesses, the ability for the immune system to fight infection may be limited. Early and accurate treatment can be critical to preventing tissue damage and loss. Redness, swelling, pain, drainage, odor, and fever are just some of the early indicators of infection. If these occur you need reach out for help or go to the emergency department.
Surgical Wounds
Surgical wound occurs when a scalpel or other instrument is used to make an incision in the skin. Even though surgical procedures are conducted in a sterile environment, healing is sometimes complicated. Quickly addressing problems after a surgery is very important to the success of the procedure. If you think you are having problems after your surgery, we strongly recommend you reach out to your surgeon for help.
Arterial Ulcers
Arteries are the blood vessels which bring blood from the heart to the arms, legs and skin. Arterial ulcers are caused when the body is not able to deliver nutrient rich blood to the skin or tissues. When skin is deprived of oxygen it quickly kills the tissue causing the formation of an open wound. In some cases, the blood flow can be restored, improving allowing oxygen to flow to the wound. Many times, the arterial blood flow can be screened with a simple ultrasound which is generally painless. If the blood flow in the arteries are blocked or restricted, treatment may be necessary to allow ulcerations to heal.
Venous wounds
Veins are the blood vessels which bring blood back to the heart from the extremities. Venous wound occurs when the veins malfunction. Veins can become stretched out, leaky and ultimately ineffective at returning blood. This causes fluid to pool in the extremities and skin leading to ulceration and wound. This increased pressure stretches the skin to its limits and limits oxygen and nutrient flow. There are many forms of treatment to help the blood return properly. Many times, compression, elevation, and bandaging of the swollen areas is necessary to improve circulation.
Lymphedema
Lymphedema is a swelling of the skin caused by excessive buildup of a fluid called lymph. this can be caused when lump nodes or lymph vessels are damaged. This damage can be caused by infection, cancer, surgery, obesity, or genetics. The lymph system acts as a filter for waste from our cells. If the flow of lymph is disrupted, it can damage the skin causing ulceration. Compression, massage, pneumatic compression garments, and wrappings are common treatment methods at encouraging lymph movement and edema.
Hyperbaric Oxygen (HBO)
Hyperbaric oxygen therapy is used for many types of chronic wounds. Oxygen has a powerful healing property when use correctly. During HBO treatments patients will breath 100% pure oxygen at an increased pressure. This causes oxygen levels rise and which is carried in the bloods plasma to tissues surrounding the wound. Chronic osteomyelitis, diabetic wounds, ischemic wounds, and radiation injuries are some common wounds that can benefit from HBO treatment.