What You Need to Know About Wound Care
If you have a wound that has not started to heal in 2 weeks or has not completely healed in 6 weeks, you may have a non-healing wound.
The most common types of non-healing wounds include:
- Diabetic foot wounds/ulcers
- Ankle and leg wounds caused by vein disease and swelling in legs
- Pressure sores (decubiti)
- Surgically created wounds
- Wounds with underlying bone infections
- Puncture wounds
- Wounds in patients with altered sensation (neuropathy) caused by a multitude of medical conditions. These wounds are most commonly found in the foot or ankle.
People who are at highest risk for non-healing wounds include:
- Diabetics with reduced sensation or poor circulation or BOTH
- Poor circulation in feet and legs (PAD) without diabetes
- Patients with venous insufficiency who develop swelling in the legs and feet
- Dialysis and transplant patients
- Patients with Raynaud’s disease with foot/toe involvement
- Patients with rheumatoid arthritis, lupus (SLE), scleroderma
Other reasons that wounds may not heal well may include:
- Nerve damage (neuropathy)
- Being inactive or immobile
- Weak immune system
- Poor nutrition
- Excess alcohol use
Slow healing acute or chronic wounds often take month to heal if not treated appropriately. The older and more delayed wound healing becomes, the less likely and more difficult it is to achieve an optimal and durable healed wound.
WOUND HEALING IS A RACE…IT IS A RACE BETWEEN THE WOUND BECOMING FULLY HEALED OR GETTING INFECTED AND DETERIORATING.
The good news is, help is available!
Experts in Wound Care Treatment
Our podiatrists, Dr. Anthony Babigian and Dr. Larry Suecof, have extensive experience with wound care. Dr. Babigian has been practicing podiatry since 1994 and provides comprehensive and quality care for all foot care needs. Dr. Suecof recently joined the Starling team and has been practicing for over 40 years. He is board-certified in wound management since 1998 and is one of only three specialists in Connecticut who is certified as a wound specialist physician (CWSP).
What to Expect at a Wound Care Visit
When you seek care from a wound specialist, the goal is to stabilize the would while initiating therapy to promote healing. Patient education while being treated and after healing is achieved then becomes the basis for prevention, which is the ultimate long term goal for patient and doctor.
During your visit, your doctor will:
- Examine and measure your wound
- Check the blood flow in the area around the wound
- Determine why it’s not healing
- Create a treatment plan
Treatment goals include:
- Healing the wound
- Preventing the wound from getting worse or becoming infected
- Preventing limb loss
- Preventing new wounds from occurring or old wounds from coming back
- Helping you stay mobile
- EDUACTION so the patient can be actively involved in prevention
In order to treat your wound, we realize that every patient and every wound is different. Delayed wound healing frequently has multiple factors at play and understanding the wound healing in each person is patient specific, every patient will have a personalized treatment plan that is optional for their particular wound.
There are different treatment options that will depend on the severity and location of the wound.
Vascular Evaluation and Consultation
The lifeblood and basis of all wound healing is blood supply which brings oxygen to the wound area. NO WOUND WILL HEAL WITHOUT ADEQUATE OXYGEN SUPPLY BROUGHT BY WAY OF OUR BLOOD VESSELS.
For this reason, circulatory evaluation is imperative and remains the basis of all initial evaluations. A wound care specialist provides an initial circulatory evaluation and will decide if you will need further workup by a vascular surgeon prior to the initiation or continuation of wound healing therapy.
Debridement is the process of removing unhealthy devitalized tissue both surrounding and within the wound/ulcer. This tissue generally needs to be removed to help your wound heal. There are many ways to do this. Depending on the type and placement of the wound, as well as patients medical condition, debridement of the wound will be debrided in office at the time of their visit, Occasionally, local anesthesia is requirement. On a very rare occasion, sedation anesthesia is required in an outpatient or inpatient setting.
Surgical debridement uses appropriate sterile instruments to:
- Debride the skin around the wound
- Check the depth of the wound
- Remove non-living, no viable tissue for the wound base
- Cleanse the wound of all unhealthy tissue which can delay healing
Other ways to remove dead or infected tissue are:
- Special creams or enzymes to painlessly digest unhealthy tissue
- Use an irrigation spray to wash away unhealthy tissues
- Apply appropriate interactive dressings to help cleanse the wound bed of devitalized tissue to stimulate healing
- Use one of the hundreds of available specialized wound topical agents to help with painless topical debridement
Keeping the wound covered
After the wound is clean, your doctor will apply a dressing to keep the wound moist and help prevent infection. There are many different types of dressings, including:
- Alginates (seaweed)
- Antibiotic creams or ointments
- No stick specialty gauze
- Silver products or specially developed lodaphor topic agents
We may use one or multiple types of dressings as your wound heals.
Additional treatment options
Your doctor may recommend other types of treatment, including:
- Bioengineering living skin (LSE)
- Human skin equivalents
- Skin substitutes derived from multiple animal species or human derived
- Bioengineered growth factor topical gel
- Wound vacuum therapy
- Ultrasound or electrical stimulation therapy
- Hyperbaric oxygen therapy
- Localized exposure oxygen therapy
- Arterial assist pumps
- Compression wrap therapy
- Lymphedema therapy
You may need to return multiple times to receive treatment for your wound. Our team will provide instructions and education on caring for your wound at home in between visits. Depending on your needs, you may also receive help with or be referred for:
- Home care nursing therapy
- Nutritional assessment
- Diabetes care/improved glucose management via your primary care physicians
- Smoking cessation
- Pain management
- Physical therapy
When to Call Your Doctor
You should call our office if you notice signs of infection, such as:
- Odor increase from wound
- Increasing drainage from wound
- Change in drainage quality or quantity from wound
- Pus or bleeding from the wound
- Pain that gets worse
- Fever, chills, shaking chills, or sweats
- Nausea, vomiting, or decrease in appetite
- Loose stools
- Decline in glucose control (increased blood sugars)
We can be reached night and day. Our answering service is available to take calls after hours.
Neglecting a wound can be very dangerous. Any wound in any patient that is not healing properly is an invitation for infection and potentially limb or life altering complications.
Dr. Suecof is now scheduling visits in Enfield and Glastonbury.
Call (860) 721-5733
Dr. Babigian sees patients in New Britain.
Call (860) 832-4666