Patients at Curatio Solutions Wound Care and Hyperbaric Medicine Centers receive the highest quality treatment available. Our caring staff are trained in both hyperbaric medicine and the latest wound care technology and understand the compounding benefits of this adjunctive plan. Patient education is a high priority for us as well. Part of every treatment plan is an intense focus on making sure that patients and families understand their disease process, how this contributes to the formation of wounds, and what will be needed to heal the wound. We also include the patient’s active participation in the treatment process, explaining what their part is in the care plan in order to maximize healing advantage opportunities. Behind every wound, several elements must exist in order for it to heal. These elements include adequate blood flow which carries oxygen and nutrition to the wound, adequate protein levels in the blood that result from a well-balanced diet, management of swelling, and management of bacteria. Below is a link to some of the most common wound types. Click on the link to read about each one to understand contributing factors in the formation of the wound and what can be done to heal them. Also available in the link are pictures so that you can compare them to wounds you or a family member may be struggling with. If these look familiar, call Curatio Solutions to find out how you can be linked with one of our centers to get started on your road to recovery!
Types of Wounds
Also known as ischemic ulcers are caused by insufficient blood flow through the artery. The most common cause is atherosclerosis but arterial ulcers can also be related to vasculitis, Raynaud’s Syndrome, sickle cell anemia and other diseases that can interrupt or hinder arterial blood flow.Location: Typically the toe area. However, they are also found over the distal part of the leg especially the outside ankle area and the top of the feet.
- Shallow or deep
- “Punched out” appearance – small and round with well-demarcated borders
- Wound base – pale and smooth
- Very painful
- Often has necrotic tissue presence (dead tissue that appears dark and leathery or soft tissue that is moist and yellow/creamy)
- Legs are more painful when elevated, less painful when hanging down
- Decreased pulses on the top of the foot and behind the ankle
- Lack of hair over the lower leg
- Skin around the wound may be bluish or very pale
These ulcers affect approximately 3.5% of people older than age 65 and account for approximately 70-90% of chronic leg ulcers. The recurrence rate is nearly 70% so once an individual has a venous ulcer, they will likely get another. . Venous ulcers develop because of poor blood flow in the veins in the legs. This insufficient blood flow can occur for a variety of reasons. The result is that the valves in the calves that open and shut when we walk to facilitate blood return to the heart are inefficient and therefore, the blood pools in the lower leg causing severe swelling in the extremity. This swelling applies pressure to the small vessles that feed blood to the skin which prevents healing.Location:30-40% of venous wounds occur above the inside ankle with the remainder forming in the lower one-third of the calf.
- Wound bed appears ruddy or beefy red
- Wound edges are flat and irregular in shape
- Drainage is moderate to heavy depending on the amount of swelling
- The shin area of the leg is often stained a brownish red color
- Pain varies from no pain to severe pain. If pain is present it is generally greater with leg(s) dependent, less when elevated
Diabetes affects nearly 16 million Americans and is the single most common underlying cause of foot or leg amputations. This is because diabetes is not just a disease of the pancreas. Diabetes eventually affects all body systems including circulation, nutrition, sensation, and numerous others. One of these affects is a sensory deficit called neuropathy. This is a deterioration of the nerves in the legs and feet which produces numbness, tingling, burning and other sensations. Many patients suffer from wounds caused by ill fitting shoes which have rubbed a blister or sore on the foot and the diabetic patient cannot feel the discomfort. Once the wound occurs, impaired circulation creates a significant disadvantage in the patient being able to heal due to a lack of blood flow to the wound. These wounds often become chronic and the longer a wound is present, the higher the risk of infection. Diabetic wounds are among some of the most complicated and difficult to heal. This is a very important reason to seek out a Curatio Solutions center to get started on an appropriate treatment plan early to minimize the risk of an eventual amputation.
Anywhere on the feet where rubbing occurs – between the toes, bottom of the foot, tips of the toes. They can also be found on the ankles, heels, and lower legs.
- Typically the wound margins will be even
- Typically the wound will be deeper rather than shallow
- The surrounding area may be inflamed and there may be infection in the bone
- Typically there will be low to moderate drainage
These wounds occur when an individual in is one position long enough to impede blood flow to skin tissue located over a bony prominence. When the blood flow stops to these areas the tissue dies and wounds occur. These wounds are typically preventable if debilitated patients are repositioned at least every two hours, incontinent patients are kept clean and dry, neuropathic patients wear shoes that fit properly, and patients eat well balanced meals that include adequate protein and keep diabetic blood sugar levels normal. Patients at highest risk for pressure ulcers are those with chronic illness that requires bed rest, dehydration, diabetes mellitus, decreased sensation or pain awareness, fractures, incontinence, malnutrition, paralysis or bedfast, poor circulation, obesity, and those who have had pressure ulcers previously.
Pressure ulcers present in many different stages and therefore listing characteristics is not practical. The best characteristic to know is that any wound located over a bony prominence and is on a high risk patient noted above is more than likely a pressure wound.
What to expect on your first visit
Once contact is made with one of the Curatio Solutions Wound Healing and Hyperbaric Medicine Centers, our front office coordinator will start the process of verifying your insurance and discussing with you the details of your plan coverage and co-pay amounts. An appointment will be set for the you to arrive at the center for an initial assessment visit.
- A wound care RN will welcome you, assess the wound(s), clean them, measure them, and photograph them
- A wound care physician will examine your wound and review your medical history to include a list of all current medications
- Labs will be drawn to obtain baseline data that will be followed throughout your treatment
- Other diagnostic testing may be done such as radiography, cultures, biopsies, etc
- The physician may remove any dead tissue that exists in or around the wound
- The wound care staff will apply the physician order treatment modality and teach the patient how to perform any needed care at home until the next visit
- A treatment plan will be discussed and decided upon with the patient and the wound care team
- Hyperbaric Oxygen Therapy may be recommended as part of the treatment course
- A follow up visit will be scheduled
- Wound care staff will undress your wound, clean it, measure it and photograph it
- The physician will assess the progress of wound healing
- Test results will be reviewed
- Dead tissue will be removed if needed
- Next steps for the treatment plan will be discussed
- Next appointment will be set
Patient Participation in Wound Healing
There are many things patients can do to speed up the wound healing process and to help ensure that wounds do not recur.
- Follow physician instructions for wound treatment at home
- Eat a healthy diet that includes significant protein intake
- Maintain appropriate blood sugar levels if the patient is a diabetic
- Take medications as ordered
- Return for all follow up visits
- Stop smoking