Make wound care a priority

Many individuals face non-healing wounds. Individuals suffering from a break in the skin leading to a wound or ulceration that has not appropriately healed within two to four weeks are at risk for a chronic wound.

Many initial injuries can be taken care of with topical wound care. At the time of the injury the individual should wash the area out with copious amounts of water. Hydrogen peroxide or alcohol can be applied to the wound initially to disinfect the wound, but then should be discontinued by the second day.

Continual use of harsh disinfectants to the wound can kill “good bacteria” that are also needed to heal the injured site. Topical antimicrobial products such as over-the-counter triple antibiotic ointments can be applied daily to the injury after a thorough cleaning with water or saline. Lastly, the injured area can be covered with an occlusive bandage to keep a moist wound bed environment.

If, despite good local wound care, the wound is not showing measurable signs of healing within two to four weeks, then expert help is needed. Wounds that have not healed within four to six weeks are considered chronic and most likely require advanced therapies that can be found in outpatient wound centers.

A few warning signs for wounds that are at risk for non-healing include ulcers with:

• The appearance of pain, redness, warmth, and/or purulence and odor despite antibiotic therapy.

• Individuals with diabetes, renal failure, or who are immune compromised either due to medications or a disease process and are suffering with wounds.

• Wounds that have not healed within two to four weeks.

• Wounds that have healed in the past and are continually re-opening.

• Wounds that have developed in areas of previous radiation.

• Individuals who are malnourished or who are nutritionally depleted.

Individuals with the above issues and are concerned that they are suffering from a wound that is not healing appropriately should alert their primary care physician or seek an opinion from a wound specialist at an outpatient wound center.

What are the benefits of seeking medical care from an outpatient wound center for hard-to-heal wounds?

Wound care teams can help “kick-start” the healing of a difficult to heal wound.

MountainView’s Wound Care and Hyperbaric Medicine Center offers:

• Thorough wound evaluation • Wound debridement

• Assessment of risk factors • Compression therapy

• Vascular diagnostics • Ostomy care

• Outpatient antibiotic management

• Negative Pressure Wound Therapy

• Artificial skin grafts

Hyperbarics (HBO) can sometimes be the key to stimulate a difficult to heal wound when everything else has failed. HBO delivers 100 percent oxygen under pressure in a large and comfortable chamber. Patients can relax while listening to music or watching television.

HBO treatments are typically prescribed five days a week, Monday through Friday for approximately 1 hour each day, for 20 days, sometimes longer.

HBO stimulates wound healing by saturating the wound with 100 percent oxygen from the inside-out. This can decrease swelling, infection and pain associated with both.

Additionally, MountainView’s Wound Care and Hyperbaric Medicine Center, wound care and hyperbaric team consists of registered nurses, hyperbaric technicians, podiatrists, and general, vascular and plastic surgeons.

After the injury

Inflammatory Phase is the body’s natural response to injury. After a wound occurs, the blood vessels around the wound contract and a clot is formed, which stops the bleeding. Once that happens, antibodies, white blood cells and other nutrients are sent to the wounded area to expedite healing. This phase can be marked by pain, swelling, heat and redness.

Epithelialization Phase is when the wounded area is being rebuilt with new, healthy tissue. This phase occurs when the body begins to create a scab, which provides temporary protection to the wound.

Maturation Phase occurs once the wound is closed. This phase is the scarring period, as the body fills in the wound with new tissue to restore the skin’s integrity.

Dr. Naz Wahab is the medical director of MountainView Hospital Wound Care and Hyperbaric Medicine Center.

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