Treatment

Dressings & Debridement

Keeping a wound clean and healthy is essential to healing. Dressings may need to be adjusted to the needs of the wound and patient. Our clinic will provide the appropriate dressings for at-home use, along with instruction, or arrange for home health services when necessary. Dressing changes are done at our office in conjunction with evaluation and possibly debridement.

Debridement involves cleaning the wound by removing dead tissue to promote healing. Regular visits for debridement by our physicians are critical for wound healing.

Diet

Wound patients can make dietary changes to improve the speed of their wound healing. For diabetic patients, this will include tight control of blood sugar levels through diet and medication. Wounds with drainage create protein loss in discharged fluid. Increasing protein in one’s diet, in addition to other key nutrients with healing properties, can play a role in wound closure. Our doctors can advise on proper diet during your wound treatment and/or refer you to a skilled dietician who can assist with meal planning.

Compression

Providing adequate compressive dressings on a wound helps promote healing by limiting the veins’ ability to expand and thereby helping blood move more efficiently to the wound. Compression wraps come in many forms, including compression stockings, edema wear, Unnaboots or Coban wraps. Our physicians have honed the technique of applying compression materials properly, resulting in the right amount of pressure to assist in wound healing.

Cellular Stimulation

Sometimes a wound needs extra stimulation to promote healing. There are a range of cellular tissue products derived from human, animal, and artificial sources that are used to improve cellular turnover at the wound site. These products often come in the form of a graft, sheet or matrix that is applied to the wound. These grafts may be derived from neonatal tissue, cadaver tissue, or animal tissues. Our physicians are knowledgeable and experienced at choosing and applying the right product for use over time in reducing the size of your specific wound.

Blood Flow Improvement

Wounds in the lower extremities may be caused by or unable to heal due to problems with blood flow to the area. Both the veins and arteries could be limiting the wound from healing at an appropriate speed. Specific testing can be ordered to identify any issues that can then be addressed by vascular surgeons or interventional cardiologists that work on blood vessels to improve blood flow.

Surgery

Sometimes surgical intervention is required to achieve wound healing, especially if the tissues in the wound are very unhealthy. Additionally, aggressive and extensive debridement is sometimes best done under general anesthesia, especially for those with painful wounds. Our physicians are surgeons who operate at local hospitals and can provide all levels of treatment. Dr. Giacona is able to provide reconstructive surgical options.

Pressure Reduction

Off-loading means ensuring that the patient rests so that minimal pressure and weight is placed on the wound. For foot and lower limb ulcers this may require total contact casting, special shoes or boots, or the use of devices such as knee scooters, crutches or walkers. For pressure ulcers, off-loading may be achieved through regular repositioning or the use of a specialty mattress or cushion. Our physicians will prescribe or supply the best option(s) for your wound and lifestyle.

Fluid Management

Drainage level management is important for a wound to heal. Negative Pressure devices like a wound vac keep drainage contained and protect the wound from further infection. The wound vac can also stimulate blood flow at the wound’s edges to help speed up healing. Our doctors can provide these devices and management.