Published: Synapse 2015 Vol. 2
It is natural to assume every wound will eventually heal. After all, most typical scrapes, cuts, and abrasions mend fairly quickly with some antiseptic ointment, a BAND-AID®, a visit to the doctor, maybe a few stitches, and a good dose of TLC. While it is true the majority of wounds do respond to traditional remedies, some do not. There are wounds that actually resist healing.
As astonishing as it may sound, wounds can linger for weeks, months, or even years without improvement. Over time, a non-healing wound may continue to grow larger, become more severe, and eventually lead to serious complications, including infection, amputation, or perhaps even death.
The good news is that even the most chronic non-healing wounds often do heal with specialized medical attention, advanced treatments, and the expertise of a skilled wound care team. The experienced medical professionals at Chester County Hospital's Wound Care and Hyperbaric Medicine Center include a cross section of experts in the field who utilize a comprehensive, multidisciplinary approach to healing wounds.
"We are able to heal wounds that have resisted healing despite months or years of conventional treatment. We have succeeded in healing wounds that others might consider hopeless. In fact, our healing rates are some of the best in the country," said Chad J. Friedman, DPM, a member of the Wound Care Center's medical team and Chief of Podiatry at Chester County Hospital.
"We treat everything from trauma wounds to burns to pressure ulcers to wounds caused or exacerbated by cancer treatment. Every wound is different and our approach to healing is unique for each specific type of wound we treat."
According to Salimi A. Wirjosemito, MD, Medical Director of the Wound Care Center, a wound might resist healing for a variety of reasons. Certain chronic conditions - including some with nothing to do with the wound itself - can complicate the healing process. Before healing can take place, it is essential to identify any underlying cause that might be preventing a wound from healing.
"Healing is a very complex process. We do not focus simply on healing the wound. We look for the reasons why the patient has the wound in the first place, why the wound isn't healing, and what might be impeding the healing process. A wound that may seem insignificant at first can become a complex wound due to a health condition that may have gone undiagnosed," said Dr. Wirjosemito, who has dedicated his career to advancing the field of wound care.
"We run diagnostic testing and seek out the expertise of other medical specialists at the hospital to help us heal wounds and minimize other health risks for our patients. For example, both diabetes and vascular disease have a detrimental effect on blood circulation and wounds will not heal without sufficient blood flow. Treating these other conditions helps us heal the wound, reduce the risk of future wounds, and improve the overall health of the patient."
People with diabetes are especially likely to have wounds that may resist healing. Diabetics are prone to developing a condition called neuropathy, which can cause the loss of feeling in the extremities. The disease also can cause poor circulation and compromise the immune system. These issues can impact the healing process.
"Imagine stepping on a sharp object and not even realizing you cut your foot. If you continue to walk on the foot without treating the wound, the outcome can be devastating. That's why so many... too many... diabetic wounds lead to amputation," explained Catherine Norris, RN, Clinical Lead Nurse at the Wound Care Center. "With the right treatment, however, a chronicdiabetic wound often can heal and amputation can be avoided. We provide that level of care and we also educate our patients about how to protect themselves in the future."
Members of the Wound Care Center team work together to design a personalized, resultsoriented treatment plan for each patient based on the specific type of wound being treated as well as other factors like the individual's health status, age, and lifestyle. Treatment may include a combination of the latest therapeutic treatments and advanced technologies available, such as specialty dressings, compression wraps, debridement, vacuum-assisted closure, and skin grafts. Every patient is closely followed and evaluated throughout the course of treatment until complete wound healing has been achieved.
Some patients with especially difficult to heal wounds may receive hyperbaric therapy (HBOT), a non-invasive procedure that involves breathing pure oxygen while lying down in a transparent, pressurized chamber. HBOT can be very effective in the treatment of diabetic extremity wounds, radiation tissue damage, crush injuries, and skin grafts.
"Many people have heard of a hyperbaric chamber for decompression illness in scuba divers, but they may have no idea how a hyperbaric chamber is used to heal wounds. Hyperbaric therapy helps stimulate new tissue growth and boosts the body's own natural wound-healing capabilities by increasing the concentration of oxygen in the blood stream, explained Benjamin Wolf, Program Director at the Wound Care Center.
"Hyperbaric therapy is not appropriate for every type of wound and it can take many sessions to achieve proper healing, but the outcomes we see with hyperbaric therapy can be pretty miraculous."
Chronic non-healing wounds are much more common than most people realize. Very often, individuals who are living with a wound that has not healed do not comprehend the dangers they face by not seeking out the specialized care available at the Wound Care Center.
"People will go a surprisingly long time with a wound that shows no sign of improvement. We know there are people in our community right now, today, with wounds that are not healing. Unfortunately, some may have given up hope for a chance of recovery. We want them to know we are here. We want them to know that not only will we provide them with the best and latest care, but we will be supportive in many other ways as well," said Catherine.
"Our compassion and commitment to our patients comes from the heart... and our patients know and appreciate that. It is impossible to put into words how rewarding it is when we see someone who was very close to losing a limb able to walk out our door on both legs with a great big smile. It's why we do what we do."
The Wound Care Center treats wounds that have not received prior medical treatment as well as those that have been treated without success. If you have a non-healing wound, do not hesitate to ask your primary care physician for a referral to The Wound Care Center or to call the Center directly at 610.738.2590.