Hyperbaric Oxygen Therapy

Lydia Corum's picture

By Lydia A Meyers RN, MSN, CWCN

Diabetes is the number one cause of amputation for wound care patients. Individuals with diabetes need monitoring and education about the dangers they face on a daily basis due to their condition. Diabetic ulcers often begin with a simple bump, as a callous or by stepping on something.

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Thomas Serena's picture

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

Parents of most children growing up in the sixties read them Winnie the Pooh. My father, a Woodrow Wilson fellow in English literature, read us Homer’s Odyssey, four times. I remember listening with excitement and anticipation as Odysseus rowed between the fearsome sea monsters Scylla and Charybdis. More than 40 years later I find myself navigating two equally challenging concepts: Efficacy and Effectiveness.

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Lydia Corum's picture

By Lydia A Meyers RN, MSN, CWCN

Radiation necrosis can be defined as cell death as a result of high doses of radiation as used with aggressive tumors. The dead cells caused by the loss of blood flow can be located anywhere in line with the radiation treatments. This damage can cause wounds that will not heal, pain and skin that can be easily damaged. Radiation necrosis can be divided into the following classifications: acute, sub-acute and delayed complications. Acute damage is direct in-line damage as well as that in the surrounding area. The cells receive damage in the DNA structure enough to prevent mitosis. This damage does not last and can be treated by controlling the symptoms. Sub-acute damage is related to the treatment of lung cancer and mimics bronchitis. Another injury that can happen is related to temporary demylinization of the spinal cord and causes Lhermitte’s syndrome. With Lhermitte’s syndrome the patient suffers electric-like shocks in the legs when stretching the spine. Delayed injuries can happen from all types of treatments and from six months to many years after the initial treatment. This could also include acute injuries that were never resolved and became chronic injuries.

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Thomas Serena's picture

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

I had the honor of lecturing to an audience of mostly European physicians at the M.I.L.A.N. Diabetic Foot Conference this past February in Milan, Italy. My session this year focused on our current and ongoing research in point-of-care diagnostics. To date, we have enrolled more than a thousand patients in a dozen clinics across the United States. All of these trials led to the development of the first commercially available wound diagnostic, WOUNDCHEK (Systagenix, Gargarve, UK), approved in Europe last year (it has not yet received FDA clearance for use in the US). A revolutionary product, I imagined that it would have received rapid, wide-spread acceptance among my European colleagues. At the end of the presentation I asked for a show of hands: “How many of you are using the test in your clinics or hospitals.” In an audience of nearly one hundred, only three attendees raised their hands.

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Michael Miller's picture

By Michael Miller DO, FACOS, FAPWCA, WCC

As we enter this New Year, I have several resolutions which I hope will act as a sextant for my upcoming wound care voyages. I promise to be less critical of my colleagues who do horrendous, insipid, unprofessional, unethical, unintelligent, profit-motivated things to patients in the name of good care…OK, maybe not. I have promised to continue my Sinbad-like voyage to find my much sought after ball-laden juggler for whom to send my much needed debridements and IV port placements. I understand that surgeons prefer to evaluate patients before elective procedures to assure that they have no potential problems and that they are low risk candidates for the requested procedure. But asking a 300 lb. paraplegic to come in to a poorly accessible office to vet them and then schedule them days later rarely identifies a reason to defer on the procedure but moreover, places the patient, their family and others at high risk and considerable inconvenience. Can you not arrange to see them early and help them later the same day?

Lydia Corum's picture

By Lydia A Meyers RN, MSN, CWCN

In recent months, I have gained insight into a problem that appears to be universal across the continuum of care and across the country as I’ve worked in different facilities and in different capacities. I have found some people accepting of new information and others that feel they know it all and are unwilling to accept information from their professional peers. As those that know me well know, wound care is my passion. The only thing that hurts more than having a peer professional discount information is seeing the impact it can have on a patient and witnessing the resulting suffering - loss of limbs, loss of quality of life and loss of independence - all because the one making the wound care decisions couldn’t see beyond the end of their nose.

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Lydia Corum's picture

By Lydia A Meyers RN, MSN, CWCN

I have heard some doctors and a number of other health care professionals talk about Hyperbaric Oxygen Therapy (HBOT) and my sense is not many of them truly understand what it does or how it works. HBOT is not a television station and it is not what Michael Jackson used in an effort to preserve his youth. HBOT is a true way to help wounds heal and create new blood vessels that promote increased circulation. HBOT helps to promote angiogenesis, which is the rebuilding of blood vessels during wound healing. It also promotes increased neutrophils to help fight infection.

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Michael Miller's picture

By Michael Miller DO, FACOS, FAPWCA

RAMBLINGS OF AN ITINERANT WOUND CARE GUY PT. 6

“IMPOSSIBLE, for a plain yellow pumpkin to become a golden carriage… But the world is full of zanies and fools, who don’t believe in sensible rules, and who won’t believe what sensible people say. And because these daft and dewy-eyed dopes keep building up impossible hopes, impossible, things are happening every day” (Rodgers and Hammerstein’s Cinderella).

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Thomas Serena's picture

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

From the third floor patio of the Foreign Correspondent’s Club (FCC), the evening breeze is a welcome respite from the sweltering heat of Phnom Penh’s hospital wards. An assortment of barges and boats strung with neon lights drifts along the Mekong Delta. This location, made famous by the movie the Killing Fields, has become the meeting place for NGOs (non-governmental organizations) and volunteers of all sorts. Nightly, we would share our tales of life and death in Cambodia’s capital city. A recurring theme was the lack of active ingredients in medicines purchased at local pharmacies. A trio of Brits complained that it was far worse in other resource poor nations. I was appalled that someone would reduce the dose of a medicine for economic gain.

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

One of the greatest honors of my life was being inducted into the Athletic Hall of Fame at The College of William and Mary. I was a gymnast there during my college days, a sport I chose early in life. My first loves were basketball and football, but I was always either too small or too light to play these sports competitively for my school teams. Even on the playground I was frequently chosen last in basketball pick-up games. To this day I remain sensitive to team picking. I recently received a call from a physical therapist looking to join my wound care team. Her hospital had enlisted the services of a management company that had marginalized the role of physical therapy in the outpatient wound care center.

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