CKHS Centers for Wound Healing and Hyperbaric Medicine and Outpatient Wound Burn Care Center
It is estimated that nearly 7 million Americans suffer from chronic wounds associated with conditions such as diabetes, peripheral vascular disease, autoimmune disease and conditions that reduce mobility. In these patients, wounds often do not respond to a conservative course of treatment over a period of six to eight weeks. Treatment by clinicians who are specially trained in wound care can help speed up the healing process, prevent recurrence and improve quality of life for these patients.
Burn wounds are in a class by themselves, requiring highly specialized care. About 500,000 patients are treated annually for burn injuries nationwide, and 25,000 of them have acute burn injuries that require admission to hospitals with specialized burn centers, according to the American Burn Association. Each year, 500 patients are admitted for care at the Nathan Speare Regional Burn Treatment Center at Crozer-Chester Medical Center.
Crozer-Keystone now has three wound care centers dedicated to the mission of aggressively managing wounds to ensure quick and complete healing, enabling patients to return to a full life free from the pain of chronic wounds:
- The Center for Wound Healing and Hyperbaric Medicine at Crozer-Chester Medical Center
- The Center for Wound Healing and Hyperbaric Medicine at Delaware County Memorial Hospital, which just opened in April 2010.
- The Burn Wound Care Center of the Nathan Speare Regional Burn Treatment Center at Crozer-Chester Medical Center
At both Centers for Wound Healing and Hyperbaric Medicine, multidisciplinary teams of vascular surgeons, plastic surgeons, podiatrists, nurses and associated health care professionals work together to provide advanced outpatient wound care that addresses each patient’s individual needs. The teams provide each patient with an evaluation, diagnosis and treatment plan, as well as education to enhance the treatment outcome and prevent recurrence.
Conditions that can benefit from comprehensive wound care include:
- Diabetic wounds
- Pressure ulcers
- Venous stasis ulcers
- Arterial ulcers
- Vasculitic ulcers
- Non-healing surgical wounds
- Complex soft tissue wounds
- Traumatic wounds
- Infected wounds
- Wounds associated with lymphedema
Hyperbaric Oxygen Therapy
In some cases, hyperbaric oxygen therapy (HBOT) is used for patients with chronic wounds that have not responded to traditional wound care treatment. The patient lies on a comfortable mattress inside a pressurized chamber, relaxes and breathes 100 percent oxygen which is carried by the red blood cells and dissolves in the blood plasma. The dissolved oxygen circulates easily throughout the body and stimulates damaged tissues to heal and white blood cells to fight infection. A treatment session lasts approximately two hours. HBOT is a non-invasive procedure with few side effects—the most common are fatigue, lightheadedness and headache.
Conditions that can benefit from HBOT include:
- Non-healing diabetic wounds of the legs and feet
- Arterial insufficiency
- Osteomyelitis, infection of the bone
- Osteoradionecrosis, radiation tissue damage to skin and bone
- Compromised skin graft/flap
- Actinomycosis, infection of the face and neck
- Necrotizing infections, characterized by death of infected tissue
- Lower extremity wounds from vascular insufficiency
- Crush injury
- Clostridial myonecrosis, also known as “gas gangrene;” infection of muscle tissue
- Carbon monoxide and cyanide poisoning
- Gas embolism
Hyperbaric oxygen therapy has been especially effective for patients with diabetic leg ulcers, according to Ponnampalam Sabanayagam, M.D., on-site clinical program director at the Center at Crozer. “Leg ulcers in those with diabetes lead to a higher rate of lower extremity amputation. HBOT helps to heal the wound quicker and has led to an 86 percent reduction risk for amputation,” he says.
To learn more about hyperbaric oxygen therapy, visit http://emedicine.medscape.com/article/1464149 for an overview article and a link to the following free CEUs:
- From Principles to Practice: A Case-Based Approach to Treating Serious Skin Infections
- Diabetic Foot Infection
- Treating Severe Soft Tissue Infections: How and What to Do
The team at Crozer includes Al Varady, RN, administrative director, Department of Surgery, Sabanayagam, and Christopher Barrett, DPM, site program manager. William Mannella, M.D., chairman of the Department of Surgery at Crozer, is the Center’s medical director. Margie Ickes, LPN, provides wound care assistance to the physicians. Mary Ellen Klements, EMT, and Amy Werner are hyperbaric technicians.
Last year, the Center at Crozer had nearly 2,400 patient visits for traditional wound care and about 1,500 for hyperbaric oxygen therapy. At Crozer, patients can self refer or be referred by nurses or physicians for care.
At DCMH, Catherine Sommers, MSHA, MS, is program director and Homayoon Pasdar, M.D., is medical director. Nursing care is provided by Jackie Stubbe, RN, WOCN, nurse case manager. Matt Klemowitz, EMT, hyperbaric technician, is trained in hyperbaric oxygen therapy.
Activity at DCMH has been brisk since the new Center opened in April. Medicare patients can self refer at DCMH; other patients need a physician referral.
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Burn Wound Care Center at Crozer
Some members of the Burn Center team.
The Burn Wound Care Center at Crozer treats patients with acute burns and recovering burns. The Center also treats burn reconstruction patients as well as patients recovering from a recent episode of skin-related processes that resemble a burn. These may include:
- Stevens-Johnson syndrome and toxic epidermal necrolysis (TEN) – life threatening skin disorders that are usually induced by a drug reaction.
- Scalded skin syndrome - infection in which the skin becomes
damaged and sheds.
- Bullous pemphigus – blistering disease of the skin and mucous membranes.
- Calciphylaxis - vascular calcification and skin necrosis
- Frost bite
- Necrotizing fasciitis – also known as “flesh-eating disease;” a soft tissue infection of muscles, skin and connective tissue.
The Burn Wound Care Center provides outpatient burn wound management, including daily wound care, physical therapy and patient education to prevent unnecessary admissions to the Regional Burn Treatment Center and foster shorter hospitalizations.
Led by Cindy Reigart, RN, BSN, clinical nursing director of the Burn Program, Linwood R. Haith, Jr., M.D. and Mary Lou Patton. M.D., Burn Program medical directors, and Robert E. Guilday, M.D., assistant medical director, the team at the Burn Wound Care Center uses cutting-edge technology and knowledge to reduce patient discomfort and promote optimal results. The team includes a burn surgeon, a physician assistant, a physical therapist and burn technicians who have undergone extensive training in wound care and are particularly expert at vacuum assisted dressings.
The Burn Wound Care Center offers scar management, burn reconstruction evaluation and can connect patients with a burn-experienced plastic surgeon when necessary. Additionally, the Center provides a comprehensive psychological and social work support systems for all ages. The Center will initiate a school reentry or work reentry program for appropriate situations.
Patients usually come to the Burn Wound Care Center for follow up care after a visit to the Emergency Department, but may also be referred by a family physician or urgent care center.“Sometimes we see patients who have been admitted to the hospital with a medical condition of unknown diagnosis, and later diagnosed with the type of problem we treat,” says Reigart.
The Burn Wound Care Center cares for more than 1,500 patients with approximately 5,000 visits annually. Patients are seen by appointment only, Monday and Tuesday, 10 a.m. to 1 p.m.; Wednesday and Thursday, 9 to 11 a.m; and Friday, 11 a.m. to 1 p.m.
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