When Cuts & Scratches Don’t Heal Quickly

For most people, cuts and scratches heal within days or weeks. But for those whose natural healing process is hampered, a simple sore can become a complex medical problem. Without proper treatment, these wounds can cause severe health risks and may result in life-threatening infections, debilitating health problems, and even amputation.

Chronic and non-healing wounds can result from a number of factors, including diabetes, poor circulation, trauma, vascular disease, and immobility, which can cause pressure ulcers, more commonly known as bed sores.

If you have a wound that won’t heal, you’re not alone. About 7 million Americans experience this problem. Non- healing wounds are on the rise largely due to an aging population and an increase in diabetes: 18.5 million Americans have diabetes and about 1.8 million of them will suffer from a problem wound.

To help these patients, many hospitals are adding wound care to their list of services. Wound care centers are outpatient, hospital-based programs that employ highly skilled teams of wound care specialists, including a case manager who will oversee every aspect of each case; thorough training for patients and families on caring for a wound at home; educational materials and resources related to prevention, nutrition and hygiene; and ongoing communication so primary care doctors receive frequent progress reports.

As skin ulceration and non-healing wounds are common symptoms of both artery and vein disease, it often falls to the vascular surgeon in a community to manage these difficult problems as part of the overall care of vascular, diabetic, and elderly patients.

Special vascular testing can help pinpoint the cause of a wound and may explain the reasons it has failed to heal with conventional treatment.

Wound care centers employ the most technologically advanced therapies in infectious disease management, physical and occupational therapy, laboratory evaluation, nutritional and pain management, diabetic education, nuclear medicine, radiology and debridement. They also address any underlying causes to help stop a recurrence.

But treatment options also include state-of-the-art Hyperbaric Oxygen Therapy, which is prescribed for about 20 percent of patients. Patients breathe 100 percent oxygen while relaxing in a pressurized chamber. The high concentration of oxygen goes into the blood stream and the wound bed to rapidly accelerate healing. It effectively fights certain types of infections, stimulates the growth of new blood vessels and improves circulation. It is also used to treat crush injuries, osteomyelitis (bone infection), skin grafts and flaps, brown recluse spider bites, and diabetic wounds of the lower extremity.

Walter Kwass, MD is Medical Director of the Center for Wound Care and Hyperbaric Medicine at Merrimack Valley Hospital, 140 Lincoln Ave. in Haverhill, MA. He is a Diplomate of the American Board of Surgery and the Vascular Board of The American Board of Surgery. He received board certification in Vascular Surgery in 1987 and recertification in 1997 and in 2007. His interest in the management of difficult wounds began with his vascular surgical career as a fellow at the New England Medical Center in Boston. He helped develop a prototype wound clinic at The Hospital of St. Raphael in Connecticut in the early 1990’s under the direction of his vascular team. Dr. Kwass is known for his expertise in vascular ultrasound and the vascular laboratory for non-invasive diagnosis. He has had experience in ultrasound scanning since 1985, including both performance and interpretation of procedures. He has been director of vascular laboratories in a number of settings and will continue this role as part of his responsibility as Medical Director.