Six million people in the United States are affected by chronic wounds each year. The experienced specialists of Jefferson’s Wound Care Program at Methodist Hospital in South Philadelphia are dedicated to the diagnosis and treatment of chronic wounds. The Program is a component of the Jefferson Vascular Center.
Jefferson is one of the only hospitals in the region to also offer complex wound care and hyperbaric treatment for surgical wounds that have not healed properly, diabetic ulcers and unusual wounds resulting from various diseases. Treatment is also available at the Jefferson Vascular Center in Center City.
To learn more about wound care at Jefferson, I reached out to Dr. Alejandro Perez, medical director of the Jefferson Vascular Center at Methodist Hospital, to answer some common questions.
What is wound care?
Advanced wound care is the evaluation and management of wounds that have not healed with conservative measures such as antibiotics and simple dressing changes, which are available for the general practitioner.
What advanced treatment methods (modalities) do you use in the Wound Care and Hyperbaric Program of the Jefferson Vascular Center in South Philadelphia?
- Compression wraps for edema control
- Footwear to provide relief for patients with diabetic foot ulcers
- The removal of dead tissue anywhere in the body (debridement)
- Skin substitute application
- Hyperbaric oxygen treatments
Hyperbaric chambers pressurize air up to three times higher than normal air pressure. Under these conditions, your lungs can gather more oxygen than would be possible breathing pure oxygen at normal air pressure. Your blood carries this oxygen throughout your body to promote healing. Hyperbaric therapy is successful in treating serious infections, bubbles of air in your blood vessels and wounds that won’t heal as a result of diabetes or radiation injury.
What type of wounds do you treat?
We treat venous ulcerations, arterial leg ulcerations and diabetic foot wounds. The hyperbaric component of our Center also helps with adjunctive treatment in the setting of compromised skin flaps, rapidly progressing skin infections, chronic osteomyelitis and diabetic foot ulcers.
Another aspect of the Hyperbaric Program is its role in treating soft tissue injuries that have resulted from past exposure to radiation. A typical example is a man who was treated in the past for prostate cancer with radiation, but now years later has persistent bleeding in the urine due to radiation cystitis. Other radiation treatments to the pelvic or rectal areas can result in persistent rectal bleeding called radiation proctitis. Patients can also receive radiation exposure as treatment for oral/neck cancers with subsequent tooth decay due to osteoradionecrosis. These patients require hyperbaric oxygen treatments both before and after their dental extraction or surgery to optimize healing rates.
What is the relationship between vascular medicine and wound care? Why is this important for patients?
The most commonly seen wounds in a wound care center have a vascular disease component. Having a physician with a specialty focus in vascular disease assures the most appropriate treatment strategy is followed.
What is the role of a vascular/wound care physician?
The wound care physician not only treats the patient to heal their wounds, but also endeavors to prevent the wound from recurring with education and good follow-up. The great majority of wounds encountered are preventable. If a patient understands the cause of their wounds, they are better equipped to be part of the treatment team.
The advantage of our Center is the vascular expertise of our physicians, allowing patients to coordinate vascular interventions when needed and better manage their ongoing vascular disease.
What do patients in need of wound care services need to know when choosing a physician/Center?
They should inquire as to what type of wounds the physician is able to treat and what advanced treatment modalities are available to assist with wound healing. They should also have an idea as to the success rate of the wound center in healing wounds.
What is a skin substitute?
Traditionally, when patients had difficult-to-heal wounds, a physician had to often take a piece of skin from one part of the body to heal another area called skin grafting. Today, there are available laboratory-engineered skin cells that can be placed on difficult-to-heal wounds to accelerate wound healing in the setting of venous ulcerations and diabetic foot ulcerations.