According to the National Institutes of Health, chronic wounds affect more than 6.5 million patients each year at a cost of more than $25 billion. Xinke Chen, MD, says these numbers are expected to increase due to the rise in diabetes, obesity and an aging population. He shares his thoughts on treatment options.
Q: What types of wounds are considered chronic?
If a wound doesn't heal by 50 percent in four weeks, you need to seek medical treatment. Certain wounds can be difficult to heal, such as pressure ulcers, as well as arterial, venous and post-op wounds. People with diabetes can have wound complications if their sugars are not controlled, and sometimes poor circulation can impede healing.
Q: How does having diabetes complicate wound healing?
In the normal healing process, inflammation at the wound site acts as a signal to the cells to heal the injury. But with diabetes, uncontrolled sugar levels in the blood interfere with cell communication and prevents the healing process from starting. Therefore, the injury remains in a state of constant inflammation and is unable to heal.
Q: How can a wound care specialist help me?
Many people think that if a wound becomes infected, antibiotics will take care of it, but not all wounds can be treated that way. If the patient has diabetes and the wound becomes infected, a procedure known as debridement removes dead tissue. Special dressings applied directly to the area allow healing to start. Weekly follow up is required until the wound is fully healed.
Q: What happens if the wound doesn't heal after initial treatment?
When healing doesn't occur after four weeks, hyperbaric oxygen therapy (HBOT) may be required. It involves breathing pure oxygen in a pressurized chamber. HBOT helps build blood vessels and causes stem cells to rush to the injured site to encourage healing. The number of sessions and amount of time for each session is based on the type of wound, but a typical course of HBOT lasts up to six weeks.