Healthtips

Wound Management is a medical specialty which has grown and changed over the years to address the needs of those afflicted with wounds that have not healed in a timely or orderly fashion. This medical discipline integrates the utilization of the latest technologies with an extensive understanding of the underlying causes of a wound’s failure to heal.

Whether due to complications from diabetes, poor circulation, or other conditions, patients who seek out Wound Specialist have usually attempted to care for their wounds on their own or with the assistance of a health professional, but with little success. The physical, economic, and emotional price for patients with chronic wounds can be debilitating and frustrating. When a lack of healing progress becomes apparent, wound management by a Certified Wound Specialist should be considered as a resource to assist in the healing process.

The most common type of wound that I treat in my practice is diabetic ulcers. Often, a combination of factors associated with diabetes such as loss of protective sensation, decreased circulation, structural foot deformities and loss of skin integrity will create the condition for the formation of a non-healing wound. A diabetic ulcer can be a simple non-healing break in the skin, or a wound that extends to deep structures and bone. They are often entry points for bacterial organisms to invade the body leading to limb or even life threatening infections.

Surprisingly, diabetic foot ulcers are often painless. Decreased ability to sense light touch or pain is usually a symptom of diabetic neuropathy. It is common for diabetic patients to step on sharp objects such as glass, tacks or nails, or to develop blisters, without ever feeling the pain usually associated with such events. This lack of “protective sensation” puts diabetic patients at high risk for developing diabetic ulcers, which in turn leads to an increased risk of amputation due to complications of non-healing wounds and infection.

Since the mid 1990s there have been many exciting advances in wound management. New products are being developed at an impressive rate. These products, coupled with a better understanding of how wounds heal, have been responsible for the preservation of limbs that might otherwise have been recommended for amputation.

Although surgical debridement remains the mainstay of treatment, healing may be enhanced through the use of several medications and dressings designed to promote moist wound healing environments. Technologically advanced products such as Regranex, a genetically engineered wound growth factor gel is now used in leau of growth factor which previously had to be manufactured from the patient’s own blood. Apligraft, is a living bi-layered tissue product manufactured from cellular components of human skin can be surgically applied to open wounds to facilitate wound closure. Patients often experience decreased pain after the application of this product, and shortened wound healing times. Vaccum assisted closure, such as the Wound VAC is a simple yet highly effective method to reduce the size of wounds, especially those extending to deep structures within the body. This method uses negative pressure to remove harmful fluids and bacteria from wounds and stimulates blood flow to the wound allowing the body to fill in the defect with its own tissue. Despite these advances, most patients are unaware of the exciting technology available in wound care. Research and product development designed to enhance wound healing is an ongoing, rapidly expanding field. Certified Wound Specialists are committed to utilizing the best advances in technology to assist our patients in healing as quickly as possible. Dr. Vogler is board certified in wound care by the American Academy of Wound Management and the American College of Foot and Ankle Surgeons. He may be reached at Family Foot and Ankle Specialists, 206 Gatewood Avenue, High Point, 802-2055