Hyperbaric Oxygen Therapy

Wound repair and regeneration comprise a complex process of biological and molecular events that consists of cell migration and proliferation, along with extracellular matrix deposition and remodeling. Unfortunately, not all wounds progress through healing easily. Certain pathophysiologic and metabolic conditions can alter the course of healing and impair or delay it, resulting in chronic, nonhealing wounds. The costs to treat nonhealing wounds can be high, and the patient’s quality of life can be impacted by any related loss of mobility or productivity. For these reasons, advanced wound care modalities and products may be introduced to help address underlying factors that impair the healing process.

Angiogenesis: The process of new blood vessel formation. This process is required for wound healing and allows for the delivery of oxygen and nutrients to the body’s tissues.

Cellular and tissue-based therapies: Advanced therapies that may use cells to induce immunomodulation in the wound bed and facilitate healing by resolving inflammation. Such modalities may include stem cells, scaffolds, skin substitutes, and epidermal substitutes, among others.

Edematous: A term to describe wounds that are affected with edema or are abnormally swollen.

By Windy Cole, DPM

In my recent WoundSource webinar, I discussed the topic of diabetic foot ulcers (DFUs) and using advanced therapies to encourage their healing. The webinar is still available for viewing on WoundSource.com. Chronic lower extremity wounds present significant challenges with regard to effective wound management. Ischemia, microcirculatory dysfunction and peripheral vascular disease cause limitations in blood flow that can delay the healing process.

By Lydia Corum RN MSN CWCN

The times are changing in the world of wound care. There used to be a time when there were no problems with reimbursements, as long as the doctor wrote the order. Today, the Centers for Medicare & Medicaid Services (CMS) regulations confuse clinicians and make the world of healing wounds much more difficult. The changes are in the area of denials with not enough information given for choosing dressings, use of negative pressure therapy and hyperbaric oxygen therapy. Are all these changes needed? Why are these changes happening? What can hospitals and wound clinics do to make things better?

By the WoundSource Editors

A vast percentage of wounds become chronically stalled because of mixed etiology and other underlying comorbid medical conditions. This means the wound is multifactorial, and using a singular approach won’t be enough. Lower extremity wounds, for example, can have diabetes, venous and arterial issues, and pressure all as factors playing into the same wound.

by Kelly Byrd-Jenkins, CWS

What you do in the outpatient center is not easy, and not everyone is doing it. In many cases, they'd prefer to let us decipher this challenging demographic's path to healing. Patients we're entrusted to serve are complex in their needs, diagnoses, and compliance with our treatment plans. We see them frequently, often over extended periods of time, and due to the very nature of their mixed, long-standing wound etiologies, we don't always get to see complete and total healing for quite some time. These are etiologies we aren't managing, but must factor in to be effective. Considerable time is spent equipping these patients for personal success by coordinating resources and providing education. And for the patient whose end goal is stability, we recognize that outcome as success each time we see them.

by Thomas E. Serena, MD, FACS, FACHM, FAPWCA

by the WoundSource Editors

Overview

Diabetic foot ulcers (DFUs) are arguably among the most difficult types of wounds to manage; the etiology of these wounds poses some of the greatest clinical challenges for healing, considering the multifaceted nature of diabetes mellitus (DM). Multiple patient-related factors must be addressed and controlled through faithful adherence to the prescribed plan of care, which is developed by both the patient and clinicians to ensure success.

by the WoundSource Editors

By Martin D. Vera LVN, CWS

In this last of our three-part series on lower extremity wounds, we will focus our attention on diabetic foot/neuropathic ulcers. Research indicates that the United States national average for diabetes mellitus (DM) accounts for a little over 8% of the nation, or roughly over 18 million Americans afflicted with this disease—what the industry refers to "the silent killer" for the amount of damage it causes. DM has the capacity to affect vision and circulation, as well as increase the incidence of stroke and renal disease, just to name a few associated problems. Over 20% of individuals with diabetes will develop ulcerations, with a recurrence rate of over 50% for diabetic foot ulcers (DFUs) alone. Overall, lower extremity wounds have recurrence rate of 40-90%. We have our work cut out for us. So, let's put our deuces up, recognize early intervention, and try our best to manage and prevent complications associated with DM.