WOUND CARE AND HYPERBARIC OXYGEN

Over the last few decades the treatment of chronic wounds (wounds that haven’t healed in 4 weeks) has become increasingly complicated and expensive. Thousands of specialized “Wound Care Centers” have cropped up across the country. The idea behind these is founded on the fact that getting these types of wounds to heal often requires physicians and nurses of different backgrounds and with special training. These centers are often made up of physicians such as podiatrists, general surgeons, orthopedic surgeons, vascular surgeons, plastic surgeons, infectious disease doctors, diabetic specialists, etc. The reason for that is that it is often the underlying medical issues such as diabetes, poor nutrition, the presence of infections, the use of drugs to treat diseases such as Lupus or Rheumatoid arthritis, that contribute to the poor healing of wounds. In addition, multiple products, surgical and nonsurgical techniques, and “advanced wound care therapies” are used when wounds just won’t heal.

Silicon Valley’s South Bay Vascular Center and Vein Institute doctors are recognized as the leading wound care doctors in the greater San Francisco Bay Area. Recognized as the one of the leading wound care doctors in the country, Dr. Kokinos serves as the medical director of both the Verity/O’Connor Wound Care Center in San Jose and the St Louise Hospital Wound Care Center in Morgan Hill, CA. Dr. Kokinos brings her cutting edge expertise in wound care to patients from all over California who come for treatment at these facilities.

One of the most “hyped” of these treatments is the use of Hyperbaric Oxygen. This is 100% oxygen (normal air is about 21%) that is pressurized in a special tank and breathed by the patient over a period of about 90-120 minutes. This is done daily for thirty to forty treatments. It has been shown that this increases oxygen delivery to the tissues around the wound, and thus increases healing. Originally used to treat “the bends” after a scuba diving accident, today, most “dives” in the hyperbaric chamber are done for wound healing. Many insurers pay for this IF

  • The treatment is used to treat certain classes of wounds and
  • The wound has failed to improve after four weeks of standard therapy.

It is critically important that those two conditions are met, as hyperbaric treatment is not only quite expensive, but does have some significant side effects associated with it.

BE ADVISED: Often times wound care centers will promote this type of advanced therapy before adequately evaluating/treating the patient for the underlying factors that can contribute to non-healing. This is particularly true for vascular causes and is why before beginning any hyperbaric oxygen treatments patients must be seen and evaluated by a Vascular Surgeon. Vascular Surgeons are uniquely trained and qualified to evaluate the state of a patient’s underlying circulatory issues and patients should only agree to this kind of therapy only after speaking with their vascular surgeon.

Previously, vascular therapies often entailed long, dangerous operations to open blocked arteries. However, now, most of these treatments are minimally invasive (done through a poke in the groin or foot) and are often done in the office. Almost all patients, no matter how old nor what other medical conditions they may have, are candidates for these safe procedures.

Hyperbaric oxygen is also used for wounds in areas that have been radiated or that are the result of diabetes. Again, it is critical to optimize all other factors before progressing to “diving” or hyperbaric treatments.

WOUND CARE

Millions of Americans suffer from wounds that don’t heal. It’s a problem most don’t even think about until they or a loved one develops this type of wound. After all, every one of us has fallen or hurt ourselves with a resulting wound. It generally hurts for a little, we put a little Neosporin or a band-aid on it, and forget about it. Pretty soon, it is gone, and there is a little or big scar in its place. However, as we get older, and develop medical issues, this healing may not happen. A wound that has been “open” for more than four weeks, is called a chronic wound, and often needs the special attention of a wound care center. In these centers, team of specially trained nurses and doctors use a variety of diagnostic and therapeutic tools to help promote healing.

Several different problems can contribute to wound healing. The most common of these is a circulation issue. Either the arteries are blocked that supply oxygen and nutrients to help heal the wound, or the veins that promote drainage of toxins and fluids are not functioning properly. This can occur either because they have leaky valves, or because they too are blocked. In general, it has been discovered that about 70% of wounds seen in wound care centers have an underlying vascular issue. This problem is most often an issue with leg or foot wounds. For this reason all of these should be consulted on by a vascular surgeon, a specialist in treating circulation problems. Simple tests, most of which are not invasive, can reveal problems in the arteries and veins. It is very important to do this, because treating these issues alone can greatly improve the wound healing rate.

Other issues that can contribute to wound healing problems include diabetes, poor nutrition, infection, pressure on the wound, and certain medications (such as steroid use). These can often be addressed by the wound care specialists and thus improving the ability of the wound to ultimately heal.

Silicon Valley’s South Bay Vascular Center and Vein Institute doctors are recognized as the leading wound care physicians in the greater San Francisco Bay Area. Dr. Kokinos is the medical director at both the Verity/O’Connor Wound Care Center in San Jose and St Louise Hospital Wound Care Center in Morgan Hill, CA. and is recognized as the regional expert in the greater San Francisco Bay Area.