Wound care

To understand how wound treatment works, you must first understand how chronic wounds occur.

A chronic wound is an area of skin breakdown that has not shown signs of improvement or does not heal properly, even after several weeks. Factors such as diabetes, poor circulation, pressure, nutritional deficits and smoking all affect the normal healing process of wounds.

When a wound fails to heal, it forms a false covering, called fibrin, which stops all of the body's natural attempts to heal the wound and can trap infection in the wound. This fibrin must be removed so new skin cells can grow and heal the wound.

Part of our wound care protocol to remove this false covering is to "trick" the body into thinking it's healed. We do this with a process called debridement, which is the removal of fibrin with an instrument called a curette.

Debridement starts the body's healing process all over again by making the body think it has a brand new wound. Debridement may need to be done on a weekly basis until the new cell growth, known as epithelialization, has occurred.

Overall, treatment will focus on the cause of the wound, coexisting conditions that impact wound healing and topical wound management. Your primary care physician or referring physician will be provided with your progress reports, and you will return to them for care after discharge.

We use hyperbaric chambers — noninvasive, clear, acrylic chambers — to promote optimal healing. During an HBOT session, 100 percent oxygen is administered at a controlled pressure (greater than sea level) for a certain amount of time, usually 90 minutes.

While breathing pure oxygen, your blood plasma becomes saturated, carrying 20 to 30 times the normal amount of oxygen to the body's tissue. This allows oxygen to reach bone and tissue normally inaccessible to red blood cells. HBOT has proven effective in stimulating healing and growth of healthy tissues. Continued use of HBOT results in more efficient functioning of the body's natural wound-healing mechanisms, which depend on oxygen.

At our center, each hyperbaric chamber has its own TV and CD player for you to watch movies or listen to music during treatments. The completely transparent chambers allow you to see and be seen by our wound care team members.

Our hospital is home to the Florida Limb Saving Institute. Here, our multidisciplinary, dedicated team provides comprehensive care to prevent amputation for patients at risk of losing a limb.

Patients who have a nonhealing ulcer with extremity numbness may be at risk of limb loss. Patients at risk for possible limb loss may also have some or all of the following co-occurring conditions or causes:

• Blood-clotting disorders
• Bone infection (osteomyelitis)
• Coronary artery disease
• Diabetes
• Hyperlipidemia
• Peripheral arterial disease
• Rest claudication
• Tobacco use

Our program at the Florida Limb Saving Institute features:

• A comprehensive evaluation by one of our physicians to develop an individualized care plan based on established protocols and your specific needs
• A team of specialists to work with you and your existing healthcare providers
• A nurse navigator to help you and your family with communication and coordination of healthcare among various healthcare providers
• Education on nutrition and diabetes management skills
• Education on off-loading, pressure relief and routine foot care
• Long-term follow-up care

Our limb saving team includes specialists from the following areas:

• Endocrinology
• Hyperbaric medicine
• Infectious disease
• Interventional cardiology
• Nursing 
• Nutrition
• Orthopedics
• Plastic and reconstructive surgery
• Podiatry
• Primary care
• Rehabilitative medicine
• Sleep medicine
• Vascular care
• Wound healing

If you sustain a wound and need emergency wound care, the emergency department at our hospital is open 24/7. Here, our emergency medicine team provides prompt, effective care for medical emergencies.