Wound Healing Center News and Events - Baptist Health System

Saving limbs - Saving lives

Wed, 01 Dec 2010 00:00:00 GMT

by Dr. Jayesh Shah ,MD,CWS

Non-healing wounds are very common in diabetics. Twenty percent of hospital admissions of diabetics are because of lower limb problems. The incidence of amputation is six per 1,000. From 1993 - 1999, approximately 67,000 amputations were performed yearly among people with diabetes. The risk of Lower-extremity amputation in people with diabetes is 15 times higher than that of non - diabetic persons and increases with age.

The triad of peripheral neuropathy (loss of sensation), poor circulation and mechanical abnormality are the major contributing factors to the formations of diabetic foot ulcers. Approximately 60 percent of these ulcers are primarily neuropathic (loss of sensation), 20 percent are primarily ischemic ( poor circulation) and 20 percent are both neuropathic and ischemic.

Structural abnormality in the foot contributes a lot to the formation of foot ulcers in diabetic because structural abnormality in the foot leads to increased pressure. When sustained by repetition, this increase in pressure can cause tissue breakdown and ultimately ulceration, which can lead to serious complications.

These three factors - neuropathy (loss of sensation), Peripheral vascular disease (poor circulation) and mechanical abnormalities - must be identified early and corrected if we are to successfully reduce the amputation rate in the diabetic population. If a high risk foot is identified, that patient should see the primary care doctor at least every six months to make sure the foot is well protected with protective (orthotic) shoes and to get examined for any new ulcerations.

Although most diabetic foot ulcers will resolve with a comprehensive wound management program which includes aggressive revascularization when indicated, some patients will develop chronic, non-healing ulcers, Inadequate treatment of chronic ulcers can lead to hospitalization owing to the development of infections and gangrene, and many patients with such severe complications may ultimately undergo amputation of the affected limb.

In last few years there has been considerable better understanding in healing of this chronic non-healing wounds, Multiple products and advanced dressing options are available like Wound Vacuum (negative pressure therapy), Dermagraf (artificial graft), Collagen dressings like OASIS and Growth factors are available to help those wounds heal faster at Wound centers. Sometimes these advanced dressings are also not able to heal wounds and there may be a need for hyperbaric oxygen therapy for some selected non-healing wound.

When the human body's natural healing ability is compromised, physicians increasingly rely on specialized wound care and, where indicated, hyperbaric oxygen therapy for non-healing wounds.

Hyperbaric oxygen therapy is a therapy during which the patient breathes pure 100 percent oxygen under increase atmospheric pressure. The air we normally breathe contains only 19-21 percent of this essential element.

The concentration of oxygen normally dissolved in the blood stream is thus raised many times above normal (up to 2000 percent). In addition to the blood, all body fluids including the lymph and cerebrospinal fluid are infused with healing benefits of this molecular oxygen.

It can allow oxygen to go the areas which are inaccessible to the red blood cells, enhance white blood cell function and promote the formation of new capillary and peripheral blood vessels. This results in increased infection control and faster healing of a wide range of conditions.

Hyperbaric oxygen therapy is also used in treatment of diabetic wounds, bone infections, crush injuries, failing skin grafts, soft tissue necrotising infections, gas gangrene, radiation tissue damage and other conditions.

Comprehensive wound management, which includes 1. Controlling edema 2. Off loading (to relieve pressure from the wounds) 3. Infection control 4.Debridement (cleaning the dead tissue) are some of the principles followed at the wound centers which helps this Non healing wounds to heal faster.

Let us join hands with American Diabetic Association and Save limbs and in turn save lives.

Dr. Jayesh Shah
Medical Director
Wound and Healing Center at Northeast Baptist Hospital

Preventing Amputation for People with Diabetes

Wed, 01 Dec 2010 00:00:00 GMT

San Antonio has the second-highest death rate for diabetes among the 54 largest U.S. cities. Diabetes can damage nerves in your feet and cause neuropathy, a condition that makes it hard for you to feel injuries or sore spots. The disease can also change blood flow, making it harder for small problems, like a blister, to heal properly. Even minor injuries can quickly become serious infections that can send you to the hospital.�

The Wound Center at Northeast Baptist Hospital opened recently to help heal infections caused by diabetes. The center features four hyperbaric chambers, which are proven to help wounds heal faster. World-renowned wound care specialist Jayesh Shah, M.D. is the Medical Director of the Wound Center at Northeast Baptist.

Go to bhswound.com or call 297-7005 to make a same day appointment.�

Saving limbs - Saving lives

Diabetes: Keeping Feet Healthy

Inspect your feet daily for problems such as redness, blisters, cracks, dry skin, or numbness. Use a mirror to see the bottoms of your feet. Or, ask for help.
Manage your diabetes. Monitor and control your blood sugar. Take all your medications as prescribed.
Avoid walking barefoot, even indoors.
Wash your feet with warm water and mild soap. Dry well, especially between toes.
Don't treat corns or calluses yourself. Talk to your doctor or podiatrist if you need assistance trimming your toenails.
Use moisturizing cream or lotion if you have dry skin, but don't use it between toes.
Don't use heating pads on your feet. If you have neuropathy, you could get a burn and not feel it.
Stop smoking. Smoking restricts blood flow and can make it harder for wounds to heal.
Have regular checkups. Foot problems can develop quickly. So be sure to follow your healthcare team's schedule for regular checkups.
Wear Proper Footwear. If areas of your feet have been damaged by too much pressure, your healthcare provider may recommend changing your footwear.
Make Sure Shoes and Socks Fit. There shouldn't be any rubbing when you walk. Wear the right shoe for any activity. Buy shoes at the end of the day, when your feet are larger. Make sure your socks fit, too. Wear soft, seamless, well-padded socks for activity. To protect your feet, avoid shoes that are open-toed or open-heeled.
Get regular exercise. It improves blood flow in your feet. It also increases foot strength and flexibility.

Tips on Preventing the Spread of MRSA and Other Germs

Tue, 24 Feb 2009 00:00:00 GMT

With the height of the flu season upon us and the common cold virus, keeping germs at bay can be a vigilant�task.�

Another serious type of germ is the Staph germ which�can also be easily spread by contact and can cause Methicillin-Resistant Staph Aureus (MRSA), a bacterial infection that�is�resistant to some antibiotics.

There are many ways to help prevent getting or spreading an MRSA infection and other bacteria and viruses. Our infection control�professionals have assembled some tips you can follow to help prevent the spread of germs.

Hand washing
Proper hand hygiene is the number one way people can protect themselves and others. Wash your hands frequently with warm soapy water. Rub between fingers and under fingernails. Lather your hands long enough to sing the "Happy Birthday" song twice (about 15 seconds), then rinse well and dry your hands. Always wash hands before eating, drinking, smoking, and applying personal products. Remember to use the paper towel to turn off the water faucet or your elbow so that your hands stay clean.��

In hospitals, we also provide alcohol based hand sanitizers. Hand sanitizers are great because they take less time to use and can be placed in areas where there is not a hand washing sink available.� We consistently educate staff and patients on the importance of hand hygiene, and we also promote this to visitors.

Antimicrobial Stewardship
One reason why some bacteria have become resistant to certain antibiotics is because people have overused antibiotic drugs. It is important to take antibiotics exactly as your doctor prescribes. Do not take antibiotics that have not been prescribed for you. Some people insist on antibiotics even for conditions that are caused by viruses (like a cold or flu). When your doctor tells you an antibiotic will not help, understand that (s)he is being a good "antimicrobial steward" and follow the treatment recommendations you receive.

Wound Care
Advise your family and other close contacts to wash their hands frequently with soap and warm water, especially if they change a bandage or touch an infected wound. Keep infections and wounds�covered with clean, dry bandages. Disposable gloves should be worn while caring for a wound.�Drainage from infected wounds can contain MRSA and can spread the bacteria to others.

Contact Precautions
If you or someone you know is ill, take care to limit contact with healthy persons to prevent the spread of illness. In the hospital, that includes using good hand hygiene practices as well as gloves and gowns when treating patients with certain communicable diseases, as well as other measures.

At home, it would involve washing your hands often, especially when touching the person who is ill and also when touching things that they have used. It might mean keeping ill children home from school, and keeping ill family members from close contact with others who are very young, very old, or are immunocompromised.�

Waste Management
Put all disposable waste such as dressings and bandages, into plastic bags and tie the bags securely. They can be thrown out with the regular garbage.

Laundry
Wash linens and clothes that become soiled with hot water and laundry detergent. Drying clothes in a hot dryer, rather than air-drying, also helps kill bacteria in clothes. Do not share personal items (e.g. towels, washcloth, razor, clothing or uniforms) that may have had contact an infected wound or dressing.

Cleaning your house
Periodically clean your room and personal items with commercial disinfectant. You can also use a fresh solution of one part bleach to 10 parts water.

Active Surveillance
At the Baptist Health System, our Infection Control Professionals lead the way in actively watching for good infection control practices (like hand washing), and monitor for opportunities for improvement.

Education
Infection Control Professionals in San Antonio work with the San Antonio Metropolitan Health District to provide speakers and education to community groups.�For more information on MRSA visit the Center for Disease Control.

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Healing Power

Wed, 30 Jan 2008 00:00:00 GMT

When the body's natural healing process and standard medical treatments don't work, people in San Antonio turn to The Wound Healing Center because of our high success rate and our state-of-the-art hyperbaric chambers. Call The Wound Healing Center to schedule your appointment at (210) 297-7520. We will talk with your doctor, so you don't have to worry about a thing.

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