Chronic wounds typically involve not only a complex cellular biology, but also other underlying medical conditions, including poorly controlled blood sugar, impaired blood flow to the wound area, cardiovascular problems, kidney disease, and nerve damage. The Winthrop wound healing team includes a range of specialists who work closely with our wound healing physicians to address these issues. Following is a list of conditions that commonly affect our wound patients and how they’re treated.
Reduced blood circulation due to plaque buildup in the arteries of the leg is a major reason why leg and foot wounds fail to heal. In these cases, a vascular surgeon will often perform a lower-leg bypass procedure or angioplasty to restore blood flow to the affected limb.
While our center is able to heal diabetic foot ulcers even when a patient’s blood sugar isn’t well controlled, working with a diabetes specialist to manage your diabetes will help speed healing and prevent new diabetic wounds from forming.
Diabetes-related nerve damage in the legs and feet is a primary cause of diabetic foot ulcers. A surgical technique known as nerve decompression can often help this condition.
Good nutrition is essential in order for chronic wounds to heal. The Winthrop Wound Center evaluates each patient’s nutritional status, and provides aggressive nutritional supplementation for anyone who is malnourished or undernourished.
Skin trauma is a primary cause both of diabetic foot ulcers—typically due to chronic friction from poorly fitting shoes—and of pressure ulcers (bed sores) on the hips, back, legs and elsewhere, due to extended periods spent lying in bed. Taking pressure off the affected skin area is essential in order to heal existing wounds and prevent new wounds from forming.
Venous insufficiency—the condition commonly associated with varicose veins, in which blood becomes “backed up” in the veins—is also a primary cause of venous ulcers. Once a venous ulcer has begun healing, working with a vascular specialist to address the underlying problems in blood flow to the veins will help prevent a recurrence.
If a chronic wound patient has a cardiovascular condition such as atherosclerosis, hypertension or arrhythmia, it can often affect blood flow to the wound region. In all such cases, we work closely with the patient’s cardiologist to insure that their condition is being treated effectively.
Impaired kidney function, a common complication of diabetes, can also affect the ability of wounds to heal. If initial tests indicates a patient’s kidney function is abnormal, we’ll work closely with our center’s nephrologists to address the condition.
There are times when a patient comes to us with an acute medical emergency known as sepsis, or system-wide inflammation, due to a severely infected wound. In these cases, we aggressively provide antibiotic therapy and other emergency treatments, including intravenous support and surgical debridement of the wound as needed, in order to stabilize the patient before proceeding with additional wound therapies.
At left, Dr. Thomas Davenport, plastic surgeon and director of surgical services at the Winthrop Wound Healing Center, consults with a patient.