Of the estimated 150,000 lower limb amputations performed in the U.S. each year, approximately 82 percent stem from a diabetic foot ulcer. When a patient with diabetes fails to keep blood glucose levels under control, a lack of blood flow to the lower limbs can result in the development of ulcerations or open sores. Symptoms include redness, increased warmth or firmness around the wound, swelling, extra drainage, pus or odor.
Some patients with diabetes can also develop peripheral neuropathy, or a loss of sensation in the lower limbs and feet. A simple cut or scrape can remain undetected and quickly develop into a severely infected wound. Patients often find themselves in the ER with a systemic infection and need urgent treatment.
It’s important for anyone with diabetes or cardiovascular disease to examine their feet and legs daily. If a wound does not heal on its own within 30 days, the risk of amputation and early death increases. In fact, a recent study shows that lower limb amputations have a three-year mortality risk of 71 percent.
“A chronic diabetic foot ulcer is one of the most common conditions we treat, and early evaluation is critical to help avoid limb loss,” said wound care specialist Catherine Yore, PA, Center for Wound Healing and Hyperbarics at Southwestern. “With proper intervention, most hard to healing wounds can be healed within four to six weeks and in most cases, amputation can be avoided.”
Wound treatment typically includes debridement, or the removal of dead tissue, management of the infection with the application of advanced wound care dressings or medications, off-loading or taking pressure off the area, and of course, keeping blood glucose levels under control. When a wound still does not respond to standard treatment, hyperbaric oxygen therapy or cellular tissue products (skin substitutes) may be indicated.
It’s important to be proactive and examine the feet and legs every day. Here are four tips for limb preservation, particularly for individuals with diabetes:
Be on the lookout for early warning signs of a diabetic foot ulcer including cuts, sores or blisters on the feet or toes that won’t heal.
Because diabetic neuropathy can prevent you from feeling very hot pavement or other items that could injure the feet, it’s important to not walk around barefoot and wear properly fitted footwear.
Keep the feet clean, moisturized, and covered! Safely trim your toenails and if you have difficulty caring for your own nails, seek help.
Manage blood glucose levels. For diabetics, the best way to prevent foot problems is to keep glucose levels under control. It will also help wounds heal more quickly.
March is National Nutrition Month, a time when healthcare providers across the country focus on helping patients optimize nutrition for better health. At the Center for Wound Healing and Hyperbarics at Southwestern Medical Center many patients battle non-healing wounds stemming from diabetes, cardiovascular disease, or other conditions. These wounds are typically located on the lower limbs or feet and have stalled in the healing process for more than 30 days, greatly impacting the patient’s quality of life. By this time, specialized wound care is needed in order to rule out infection and avoid the risk of amputation.
Every 3 minutes and 30 seconds in the United States, a limb is amputated due to diabetes, and as high as 80% of non-traumatic lower limb amputations happen due to diabetes complications. Because diet is such an important factor in diabetes and many other diseases, any wound care treatment plan should include a thorough evaluation of the patient’s nutritional intake.
“At the Center for Wound Healing and Hyperbarics, we discuss dietary habits at every visit and encourage patients to think of the food they eat as medicine for their body,” said Jennifer James, MD, Medical Director. “Good nutritional habits can go a long way in terms of faster wound healing. Eating right can also help prevent the development of chronic wounds in the future.”
According to the Academy of Nutrition and Dietetics nutritional needs change as we age and our diets occasionally need to be adjusted. Many wound care patients are seniors with underlying health issues and nutritional intake is a key component of the healing process. Here are six tips to help make positive dietary changes:
Before grocery shopping, create a weekly plan for balanced meals that include protein, fruits, vegetables, low-fat or non-fat dairy, and whole grains. Create a shopping list to stay on track.
Eat protein-rich foods including lean meats and seafood, skinless poultry, eggs, and tofu. Yogurt is also a good source but it’s important to check the sugar content. Protein is a major building block in wound healing because it builds muscle, skin, and other body tissues.
Consume at least one daily serving of a good source of Vitamin C, such as oranges or grapefruits. Other great choices include strawberries, broccoli, kale, and red & green peppers. Vitamin C is often aligned with wound healing because of its role in collagen formation.
Stay hydrated by drinking plenty of fluids throughout the day. Water is ideal but if you consume other beverages be mindful of sugar intake.
Consistently monitor blood sugar levels for better control. This is critical because research shows a clear correlation between blood glucose and wound healing.
Eat “good” carbohydrates if you are trying to control your weight. Whole-grain and high-fiber carbohydrates are good choices. They are found in whole grain breads, cereals, brown rice, beans, fruits with skin, and berries.
Multivitamins and mineral supplements are sometimes recommended for patients who do not consume an optimal diet or have medical conditions that impact nutritional intake. A supplement can help fill in the gaps. Discuss supplementation with your physician before starting one.
If you feel your nutritional challenges are complicated and additional support is needed, a Registered Dietitian (RD) can help you learn about nutrition and create a customized eating plan. Medical nutrition therapy with an RD is covered by most insurance plans as well as Medicare Part B. For more information or if you have a non-healing wound, give us a call at 580-531-6441.
Peripheral Artery disease (PAD) is a common circulatory problem that affects over 8.5 million U.S. adults and it has a 5 times higher mortality rate than leading cancers. Stemming from fatty build-up, or atherosclerosis, in the arteries, PAD causes blood vessels in the limbs to narrow. This can significantly reduce blood flow which can lead to a non-healing wound if an injury occurs. If left untreated, these wounds can become infected, and put patients at risk of sepsis, gangrene, or even amputation.
Risk factors include aging, diabetes, obesity, and smoking. However, only around 25% of the population is aware of the disease, and many go undiagnosed. Symptoms include pain, cramping, discoloration, and swelling of the legs or feet. The most common wound types associated with PAD are Arterial, Venous, and Diabetic Foot Ulcers.
Arterial ulcers: Also referred to as ischemic ulcers, these are caused by damaged or blocked arteries which are unable to get nutrient-rich blood and oxygen to the lower extremities. This causes an ulcer or a break in the skin. Arterial ulcers are typically located on the foot or ankle.
Diabetic neuropathic ulcers: Many patients with peripheral artery disease also suffer from diabetes. Approximately 25 percent of individuals with diabetes will experience a non-healing open wound or diabetic ulcer caused by pressure or trauma on the lower limbs or feet. Because diabetic neuropathy causes a loss of sensation in the limbs, many patients don’t know they have an ulcer until it becomes infected.
Venous ulcers: When patients have poor blood circulation in the legs, the blood can back up and “pool” in the veins, causing an ulcer. This can cause a painful open wound and edema, or swelling, on the ankles or lower leg.
Tips to Manage PAD:
With lifestyle changes and a commitment to treatment, PAD can be managed. Here are eight tips to help:
Lose weight (if overweight) or maintain your current healthy weight
Maintain a structured exercise program
Eat a well-balanced, heart-healthy diet
Control diabetes and high blood pressure
Stop smoking
Limit alcohol intake
Avoid standing for long periods of time
Wear compression wraps/stockings
At the Center for Wound Healing and Hyperbarics at Southwestern Medical Center, we’re using advanced wound care modalities and hyperbaric oxygen therapy to treat non-healing wounds caused by peripheral artery disease, including venous and arterial ulcers. Stalled wounds can be diagnosed, effectively managed and healed, oftentimes within eight weeks. If you or someone you love has a non-healing wound, give us a call at 580-531-6441 for more information and assistance or click here.
Come August with the sweltering temperature, it’s either in-door, in-water, or in-the-dark activities only to beat that late summer heat. However, whether you are scampering across the “cool” deck to the pool, or finally kicking back on the patio after the sun goes down, the heat is still there. And so is the risk of developing a wound. Especially for the 37.3 million Americans living with diabetes. Good thing Woundless Summer goes all summer long, because we’ve got all of the party favors to keep patients woundless during those hot Summer Nights, and what to look out for as summer comes to an end.
August can be brutally hot, and even when the sun goes down things like sand, pavement, concrete, and even that fancy cool-deck can still be holding the day’s trapped heat. So, before kicking off your party shoes after sunset, consider how hot it was that day. Anything that is above 111 degree Fahrenheit can start to damage the skin when touched, and at 118 degrees (just TWO degrees below the temp of a rare steak) the skin will experience a first-degree burn. And the only thing that should be burning hot on a Woundless Summer night is the grill.
The heat is why the beach, poolside, or the patio, are the best places to celebrate during a warm summer night. All with the goal of waking up without a new wound the next morning. And a headache. However, those with Diabetes, especially those who are experiencing neuropathy, should always perform regular foot checks after a long summer night out, or can we be honest here and just say the entire summer? Between the heat, wearing sandals, and probably not drinking enough water between adult beverages, the feet are the best way to tell if it was truly a Woundless Summer.
Before whipping out the magnifying glass or hand-held mirror, here is what to look for on the foot:
Cuts, blisters, and bruises.
Cracks, hardened skin (calluses), or severe dryness on the heel.
Red areas that are hot to the touch and any swelling.
Any one of these can lead to a Diabetic Foot Ulcer and should be monitored closely. If healing does not begin within the first two days, especially if the skin has broken, a doctor should be contacted immediately for further investigation. To prevent further skin damage, be sure to moisture the feet daily, especially if those dancing shoes did come off, or if time was spent barefoot in and out of a pool.
When it comes to the process of looking at the foot for any sign of a new wound developing, remember SUMMER:
Sides - Look on both sides of the foot and run your fingers across to feel for any obstruction.
Under - To look under the foot, use a hand-held mirror to make it easier.
Moisture - Feel and look for anywhere the skin is lacking moisture.
Maceration - Feel and look for any skin damage from prolonged exposure to water or wearing wet shoes for too long.
Each Toe - Inspect each toe and between toes for any friction spots or blisters.
Rub - Rub the foot to feel for any changes in shape, as well as any lumps or bumps under the skin. This will also help with circulation.
With SUMMER and CCR (not the band, but cuts, cracks, and redness), Woundless Summer can continue to live on, even long after the days become short, and the leaves begin to change. Light the tiki torches and cheers to the beach, summer camp, and the remaining warm nights ahead of us.
The Center for Wound Healing and Hyperbarics at Southwestern Medical Center is highlighting Wound Healing Awareness Month (WHAM) in June. WHAM is a time to recognize those who are paddling through the rough waters of the healing process trying to catch a break. So, to truly celebrate Wound Healing Awareness Month, The Center for Wound Healing offers those living with or at risk of developing a chronic wound prevention and care tips for a Woundless Summer.
Living with a chronic wound is not all beaches and margaritas, and for the 8.2 million Americans affected by a wound, that’s their reality when trying to feel those summer vibes. Not only is living with a non-healing wound painful, but it can quickly pull you into the undertow if not properly cared for. In fact, every 30 seconds a diabetic patient suffers an amputation, and those who go through limb loss have a 60% mortality rate within 5 years of amputation. That means more limbs are lost to diabetes than to a shark out surfing.
Don’t flounder just yet. WHAM is dropping in with all the essential tips to continue healing and prevent future wounds while doing all things summer. Here are 10 tips to keep your feet woundless all summer long:
Don’t Walk Outside Barefoot - Broken glass, rocks, trash, or debris can perforate the skin and cause infection. Walking on hot sidewalks or sand can quickly cause blisters or burns on the feet.
Always Wear Properly Fitted Shoes - If needed, ask your physician about special diabetic shoes, custom inserts, and socks to keep your feet healthy while you remain active.
Check Your Flip Flops - Debris can easily get stuck between your sandal and foot while wearing flip flops. Check them often or avoid wearing them. Examine the tops and bottoms of your feet each daily.
Stay Hydrated - This may help with foot swelling from heat or exercise and improve circulation. Hydration and a balanced diet help maintain good health for wound healing.
Monitor Blood Glucose - Proper levels of blood glucose, A1C labs, consume a healthy diet, and use medication as prescribed.
Dry Your Feet - Feet that have been submerged in water for too long become susceptible to skin tears and blisters. Take “dry-out” breaks when spending time in the water this summer.
Use Antibiotic Cream - If you have a foot wound of any kind, clean it and apply a sterile bandage to cover it, and call your physician’s office for guidance.
Avoid Heat if Wounded - Heat causes swelling/edema to worsen, make sure to see your doctor as soon as you get any foot wound.
Put Your Feet Up - Swelling can become worse in the summer heat, make sure to kick-back in a cool place and put your feet up. On hot and busy summer days, try 3-4 times a day for at least 15 minutes each.
Compress the Heat - Even though wearing an extra layer like a compression sock or wrap in the summer does not sound appealing, socks and wraps keep the blood flowing, which will help reduce swelling.
By following these tips and being aware of the impact the hot months have on your flippers; pool parties, standing around a barbecue, soaking in the long days, some of the best parts of celebrating the summer months do not have to be a total wipe-out on the healing process. Those living with a chronic wound should still be a part of the summer staples and enjoy them. Wear appropriate shoes, drink more H2O than sugary or alcoholic beverages, and score more points in the healing process.
If you or someone you love is suffering from a non-healing wound, contact the team of experts at The Center for Wound Healing and Hyperbarics at Southwestern Medical Center. They work with referring physicians to evaluate and treat non-healing wounds as quickly as possible before they become life-threatening conditions.
The Center for Wound Healing & Hyperbarics at Southwestern Medical Center is recognizing American Heart Month by offering information and tips to educate patients about heart health and chronic wounds. Heart disease is the leading cause of death in Americans, and each year nearly 700,000 Americans are diagnosed with heart disease, which causes about 1 in 5 U.S. deaths, according to the Centers for Disease Control (CDC). Related complications like vascular insufficiency or peripheral artery disease can result in the development of non-healing wounds putting patients at risk of infection, sepsis, or lower limb amputation.
Due to an aging population as well as an increase in heart disease, diabetes and obesity, the need for specialized wound care continues to grow. Currently, there are approximately 9-12 million Americans suffering from chronic wounds or non-healing ulcers on the lower limbs or feet. Many patients postpone treatment with hope that their wound will heal on its own, only to seek treatment after it has become severely infected.
“It is not uncommon for cardiology patients to develop painful, non-healing wounds stemming from poor circulation to the lower extremities,” said Catherine Yore, PA-C, wound care expert at the Center. for Wound Healing & Hyperbarics “If left untreated, this can progress to a life-threatening condition. It’s important for anyone with a non-healing wound to talk to their doctor as early as possible and get an evaluation in order to avoid sepsis or amputation.”
Common Wound Types in Patients with Cardiovascular Disease
Without proper blood flow from the heart chronic wounds can develop and not only fail to heal, but they can grow in size and become infected. Here are the three most common non-healing wounds for patients with heart disease:
Arterial ulcers: Also referred to as ischemic ulcers, these are caused by damaged or blocked arteries which are unable to get nutrient-rich blood and oxygen to the lower extremities. This causes an ulcer or a break in the skin. Arterial ulcers are typically located on the foot or ankle.
Venous ulcers: When patients have poor blood circulation in the legs, the blood backs up and “pools” in the veins, causing an ulcer. This can cause a painful open wound and edema on the ankles or lower leg.
Diabetic neuropathic ulcers: Many patients with cardiovascular disease also suffer from diabetes. Of the 34.2 million Americans suffering from Diabetes, approximately 25 percent of individuals with diabetes will experience a non-healing open wound. Because diabetic neuropathy causes a loss of sensation in the limbs, many patients don’t know they have an ulcer until it becomes infected.
Tips for Better Heart Health
If you have heart disease or are in treatment for a non-healing wound, it’s important to pay attention to your cardiovascular health. A healthy heart stimulates the circulation of oxygen and nutrient-rich blood throughout the body, skin, and tissues and stimulates the body’s healing process. Here are six tips:
Eat a healthy diet with plenty of fruits and vegetables
Exercise for at least 30 minutes three times a week
Maintain a healthy weight in order to avoid high blood pressure, high cholesterol and diabetes
Don’t smoke and limit alcohol
Get quality sleep
Manage stress
At the Center for Wound Healing & Hyperbarics, we’re using advanced wound care modalities and hyperbaric oxygen therapy to treat non-healing wounds caused by cardiovascular disease complications including venous and arterial ulcers. Chronic wounds can be diagnosed, effectively managed and ultimately healed, oftentimes within eight weeks. If you or someone you love has a non-healing wound, give us a call at 580-531-6441 or click here for more information and assistance.
Peripheral artery disease (PAD) is a common circulatory problem stemming from fatty build-up, or atherosclerosis, in the arteries. Also known as peripheral vascular disease (PVD), PAD causes blood vessels in the limbs to narrow, significantly reducing blood flow and sometimes causing the development of a wound that is slow to heal. If left untreated, these wounds can become infected and put patients at risk of sepsis, gangrene, or amputation.
PAD affects over 8.5 million U.S. adults and over 113 million people worldwide. Risk factors include aging, diabetes, obesity, and smoking. Symptoms include pain, cramping, discoloration, and swelling of the legs or feet. If you’ve been diagnosed with PAD and have a chronic wound that hasn’t healed within 30 days, it’s very important to have it evaluated and treated in order to save the limb and control the disease.
Types of Chronic Wounds in Patients with PAD/PVD
Here are the three of the most common non-healing wounds for patients with PAD/PVD:
Arterial ulcers: Also referred to as ischemic ulcers, these are caused by damaged or blocked arteries which are unable to get nutrient-rich blood and oxygen to the lower extremities. This causes an ulcer or a break in the skin. Arterial ulcers are typically located on the foot or ankle.
Diabetic neuropathic ulcers: Many patients with peripheral artery disease also suffer from diabetes. Approximately 25 percent of individuals with diabetes will experience a non-healing open wound or diabetic ulcer caused by pressure or trauma on the lower limbs or feet. Because diabetic neuropathy causes a loss of sensation in the limbs, many patients don’t know they have an ulcer until it becomes infected.
Venous ulcers: When patients have poor blood circulation in the legs, the blood can back up and “pool” in the veins, causing an ulcer. This can cause a painful open wound and edema, or swelling, on the ankles or lower leg.
Tips to Manage PAD
With lifestyle changes and a commitment to treatment, PAD can be managed. Here are eight tips to help:
Lose weight (if overweight) or maintain your current healthy weight
Maintain a structured exercise program
Eat a well-balanced, heart-healthy diet
Control diabetes and high blood pressure
Stop smoking
Limit alcohol intake
Avoid standing for long periods of time
Wear compression wraps/stockings
At the Center for Wound Healing & Hyperbarics, we’re using advanced wound care modalities and hyperbaric oxygen therapy to treat non-healing wounds caused by peripheral artery disease, including venous and arterial ulcers. Chronic wounds can be diagnosed, effectively managed and healed, oftentimes within eight weeks. If you or someone you love has a non-healing wound, give us a call at 580-531-6441 for more information and assistance.
Osteomyelitis, or an infection of the bone, occurs when bacteria travels through the bloodstream or an open wound, to a weakened spot in the bone or marrow. It is a growing concern in modern healthcare, particularly with the rise in antibiotic resistance bacteria. Individuals with diabetes are at high risk of developing osteomyelitis because they are more susceptible to the development of chronic wounds, particularly on the feet or lower limbs. When coupled with diabetic neuropathy, a loss of sensation in the lower limbs, the condition can fester for months without the patient feeling any pain.
Osteomyelitis can develop any time a bone is vulnerable or exposed: after a puncture wound or trauma, near a surgical site, after joint replacement, or as a complication after amputation. Approximately one in 675 U.S. hospital admissions each year (50,000 cases annually) is due to osteomyelitis. Patients with diabetes, immunocompromised individuals, and patients on hemodialysis are at increased risk. Here are answers to six common questions about osteomyelitis:
How Does Osteomyelitis Present Itself? When an infection (typically Staphylococcus aureus) reaches the bone, a lack of blood flow to the area deprives it of bacteria-fighting oxygen and the infection escalates, putting the patient at risk of bone death. Common symptoms of osteomyelitis include swelling and redness, a burning sensation, skin drainage (yellow pus), fatigue, fever, and pain. Specialized wound care is necessary to treat the condition and prevent the development of chronic or recurring osteomyelitis, which often requires ongoing care.
What Do Diabetics Need to Know? Individuals with diabetes are at very high risk of developing osteomyelitis on the bony structures of the lower limbs or feet as well as other parts of the body. Foot complications are the most frequent reason for patients with diabetes to be hospitalized, accounting for 25 percent of all admissions in the United States. It is estimated that 60 percent of diabetic foot ulcers are complicated by an infection and more than two thirds of this group suffers from lower limb amputation because of the infection.
When is a Wound Care Consultation Needed? If any wound has not healed in more than 30 days it’s important for patients to contact their primary physician for evaluation and consideration for referral to a wound care physician. Some insurances, including Medicare, allow for self referral to a specialized wound care center. If osteomyelitis is suspected, special care will be taken to diagnose and aggressively treat the infection in order to prevent the condition from deteriorating and leading to possible amputation.
How is Osteomyelitis Diagnosed? Osteomyelitis can be diagnosed by magnetic resonance imaging (MRI), bone culture, bone scan or bone biopsy (a piece of the bone is removed and tested for bacteria, most commonly Staphylococcus aureus). In addition, some blood tests may reveal elevated levels of white blood cells and other factors indicating that the body is fighting infection.
How is Osteomyelitis Treated? Treatment for osteomyelitis includes aggressive antibiotics and surgical debridement to clean out the infected bone. Sometimes antibiotics do not penetrate the bone adequately enough to heal it. If the osteomyelitis becomes chronic (lasting 6 weeks or longer) and refractive (not responding to treatment) it can be much more difficult to treat. In some cases, hyperbaric oxygen therapy (HBOT) may be prescribed in conjunction with an antibiotic regimen in order to improve outcomes.
What is Hyperbaric Oxygen Therapy (HBOT) and How Does it Treat Osteomyelitis? During HBOT the patient is given 100 percent oxygen in a hyperbaric chamber with a technician nearby. Increased oxygen in the bloodstream greatly enhances the ability of white blood cells to kill bacteria, reduce swelling and allow new blood vessels to grow more rapidly into affected areas including the tissues and bones. Typically used as an adjunctive treatment along with an antibiotic regimen, 20-40 HBOT sessions are required to achieve sustained therapeutic benefit for patients with osteomyelitis.
If you or someone you know has a wound that is not healing or if osteomyelitis is suspected, a wound care and hyperbaric medicine specialist should be consulted as soon as possible. For more information, contact the Center for Wound Healing & Hyperbarics at Southwestern Medical Center at 580-531-6441.
Ahh. . . Summer. Long hot days enjoying too much sun, sand between the toes, and the delicious benefits of outdoor cooking. The laid back vibes in these months are not the easiest to create when trying to thwart off a wound from coming on. Actually, the patients most at risk of developing a chronic wound are dealing with a strong undertow of conditions, like diabetes, and that can be a real buzz kill when it comes to summer fun.
If you have any underlying condition, like diabetes, you need to be vigilant about foot care while participating in summer activities. Any hot-spots or areas of concern appear on your feet during the summer months, contact your care team immediately, preventative care is always the number one priority.
Luckily, the surf is still up for those patients, just with some extra precautions. Before paddling out to the horizon, use the below tips for a solid tow-in to a Woundless Summer;
Don’t Walk Outside Barefoot Broken glass, rocks, trash or debris can perforate the skin and cause infection. Walking on hot sidewalks or sand can quickly cause blisters or burns on the feet.
Always Wear Properly-Fitted Shoes If needed, ask your physician about special diabetic shoes, custom inserts and socks to keep your feet healthy while you remain active.
Mindful of Campfires Be mindful of sitting too close to campfires, feet and legs can easily burn if not monitored. Especially those with neuropathy.
Examine Feet Daily Examine the tops and bottoms of your feet each day and keep your toenails clipped straight across and filed.
Stay Hydrated This may help with foot swelling from heat or exercise and improve circulation.
Monitor Blood Glucose
Proper levels of blood glucose, A1C labs, consume a healthy diet, and use medication as prescribed.
Dry Your Feet Feet that have been submerged in water for too long become susceptible to skin-tears and blisters. Take “dry-out” breaks when spending time in the water this summer.
Avoid Fireworks Avoid lighting fireworks, their sparks and explosions can be unpredictable, causing a serious burn.
Check your Flip Flops Debris can easily get stuck between your sandal and foot while wearing flip flops. Check them often or avoid wearing them.
Monitor Food and Alcohol Fatty foods and alcohol cause inflammation in the body, and make the skin more susceptible to breaking down.
For a Woundless Summer to never end, practice prevention and always be prepared for the day ahead.
The Center for Wound Healing & Hyperbarics specializes in the healing of chronic wounds. Our team is specially trained in treating wounds that have resisted healing after weeks or months of traditional treatment. For more information or to schedule an appointment, call 580-531-6441.
“Packing for the journey was important. Six pairs of trunks, two boxes of wax, some modern sounds, and in case of injury, one Band-Aid.” - Endless Summer (1965)
But maybe throw in an extra Band-Aid or two!
Click here for more health-related articles on wound care prevention and treatment.
For many, summer is the perfect time to run barefoot on the beach or in a grassy park. But if you’re one of the 34.2 million Americans living with diabetes, going barefoot is one of the worst things you can do for your health. Exposure to hot sand, pavement, rocks, trash and debris can result in trauma leading to non-healing wounds that put you at risk of infection, sepsis, or amputation.
Many complex wounds begin with a very small scrape or scratch. Some diabetics have peripheral neuropathy, or a loss of sensation in the lower extremities due to nerve damage. Because of this loss of feeling, a wound can remain unnoticed for quite some time and become infected, making the individual more vulnerable to delayed healing, progression of wounds, and even sepsis.
Here are seven summer foot care tips for patients with diabetes:
Don’t walk outside barefoot. Broken glass, rocks, trash or debris can perforate the skin and cause infection. Walking on hot sidewalks or sand can quickly cause blisters or burns on the feet
Always wear properly-fitted shoes. If needed, ask your physician about special diabetic shoes, custom inserts and socks to keep your feet healthy while you remain active
Keep your feet clean. Examine the tops and bottoms of your feet each day and keep your toenails clipped straight across and filed
Use an emollient cream for dry skin every day on the tops and bottoms of your feet
Stay hydrated! This may help with foot swelling from heat or exercise and improve circulation
Monitor and maintain proper levels of blood glucose, A1C labs, consume a healthy diet, and use medication as prescribed
If you have a foot wound of any kind, clean it, use antibiotic cream and a sterile bandage to cover it, and call your physician’s office for guidance
The Center for Wound Healing & Hyperbarics at Southwestern Medical Center specializes in the healing of chronic wounds. Our team is specially trained in treating wounds that have resisted healing after weeks or months of traditional treatment. For more information click here or to speak to someone about scheduling an appointment, call 580-531-6441.
When the average person hears the term “wound care” they often think of cuts, scrapes, tourniquets, or bandages. But specialized wound care programs are much more; they play a vital role within the communities they serve. June is Wound Healing Awareness Month (WHAM), a time to recognize the challenges faced by individuals with non-healing wounds and increase awareness of how specialized care can save limbs and lives.
In the U.S., nearly 7 million people suffer from chronic wounds including diabetic foot ulcers, venous ulcers, and pressure injuries (bed sores). Early evaluation and treatment is very important to help avoid complications including infection, sepsis, or amputation.
The majority of wound care patients have been diagnosed with diabetes, which can greatly impact wound healing. Of the 34 million people in the U.S. who have been diagnosed, approximately 150,000 will lose a limb after a chronic wound becomes severely infected.
“In most cases, non-traumatic lower extremity amputations can be avoided,” said Catherine Yore, PA at the Center for Wound Healing & Hyperbarics. “With early detection, proper evaluation and specialized treatment, most wounds can be healed in eight weeks or less. Our primary goal is to help patients avoid the drastic measure of removing a limb, foot, or toe.”
The Center for Wound Healing & Hyperbarics at Southwestern Medical Center treats a variety of chronic wounds and conditions, including radiation injuries to the tissues following cancer treatment. Treatment modalities include debridement, or the removal of dead skin and tissue to stimulate healing; and hyperbaric oxygen therapy, which can speed healing by carrying extra oxygen to the blood, organs and tissues. Our physicians may also recommend compression stockings, artificial skin, or negative pressure therapy.
Here are six things you need to know about specialized wound care:
If you have a wound anywhere on the body that hasn’t healed within 3-4 weeks (earlier if you have diabetes) ask your doctor to refer you to a wound care specialist. Don’t “tough it out” or try to heal the wound on your own. Patients can avoid many complications by consulting with a wound care physician early on.
Inspect your feet daily and keep them clean. If you have pedicures, be sure everything used on your feet is thoroughly sanitized.
Be aware of diabetic neuropathy. Many diabetics don’t feel pain in the legs and feet because high glucose levels over time can damage the nerves in the lower limbs. A chronic wound can remain undetected for several weeks, causing an infection to develop and rage out of control.
Control blood glucose levels. Elevations in blood glucose reduce the body’s ability to fight off infection and can slow the body’s healing process. Keeping glucose levels under control helps prevent hardening of the arteries, narrowing of the blood vessels, and nerve damage.
Learn about hyperbaric oxygen therapy (HBOT). If you’re a cancer patient suffering from the late effects of radiation treatment - even if it’s months or years later - ask your physician about HBOT. HBOT can help rejuvenate the skin and tissues by pumping oxygen-rich blood to damaged areas, encouraging healing.
Smoking, excessive alcohol consumption and poor diet/obesity can play a role in the development of chronic wounds and can negatively impact healing. Do everything you can to live a healthier lifestyle.
If you or someone you love is suffering from a non-healing wound, contact our team of experts at the Center for Wound Healing & Hyperbarics. We work with referring physicians to evaluate and treat non-healing wounds as quickly as possible, before they become life-threatening conditions.
May is Skin Cancer Awareness Month. Did you know that 1 in 5 Americans will develop skin cancer in their lifetime? If detected early, most basal or squamous cell cancers are highly treatable. But in some cases, a more invasive cancer like melanoma may require surgery and radiation therapy. Skin grafting, or the removal of skin from an unaffected area and using it to cover lost or damaged skin, is sometimes also needed for wound closure and healing.
The surgical application of skin grafts or flaps can increase the likelihood of infection so great care must be taken during recovery. Some surgical sites do not heal properly because radiation can dramatically reduce blood flow and much-needed oxygenation to the skin and tissues. If wound healing is significantly compromised, the patient’s physician – typically an oncologist, dermatologist or plastic surgeon – may recommend hyperbaric oxygen therapy (HBOT) to promote healing and preserve the skin. It is a safe, non-invasive treatment that targets and repairs damaged organs and tissues.
During HBOT the patient is placed in a hyperbaric chamber and breathes 100 percent oxygen under atmospheric pressure up to three times higher than normal. This boosts oxygen levels in the affected tissues, helps prevent infection, and promotes healing by encouraging the formation of new blood vessels.
In addition to faster healing, HBOT can reduce the need for additional surgical procedures. It can also help patients avoid further trauma and negative psychosocial effects due to aesthetics. Many skin cancer patients who require skin grafting report that HBOT has given them a new lease on life.
If you or someone you love has had aggressive treatment for skin cancer and suffers from a non-healing wound, ask your physician about hyperbaric oxygen therapy. For more information, please contact the Center for Wound Healing & Hyperbarics at 580-531-6441.
Did you know that – according to the Asthma and Allergy Foundation of America – more than 50 million Americans suffer from a type of allergy each year? That makes allergies the sixth leading cause of chronic illness in the U.S. And seasonal allergies account for a big percentage.
An allergen is something your immune system reacts to when that something touches or enters your body. There are food allergens, skin allergens and – during certain times of the year – seasonal allergens like the tree and grass pollination that occurs in spring and summer.
When these seasonal allergens make themselves known, they can cause a litany of potentially miserable symptoms in many of us, like:
Sneezing
Itching of the eyes, nose or roof of the mouth
Runny nose or nasal congestion
Watery, red or swollen eyes
Sore throat and/or cough and
Fatigue and weakness.
Misery may love company but, while these symptoms are common, it doesn’t make them any easier to deal with. Fortunately, there are some steps you can take to help manage your seasonal allergies and ease your springtime suffering.
Be aware. Many allergy sufferers actually experience year-round symptoms that aren’t as prominent or noticeable in the “off-seasons.” To better control your suffering and minimize your symptoms, it’s important to know what exactly triggers your allergies. An allergist can help you identify what’s causing your attacks and work with you to develop a plan to minimize your symptoms.
Additionally, check daily weather reports for pollen and mold counts so you’re better prepared for heading outdoors or deciding to stay inside that day.
Take action. In addition to making an appointment with an allergist, there are other actions you can take to protect yourself. If the pollen or mold count is high, or you know you’re going to be outside for a long time, think about wearing a mask to protect your mouth and nose from allergen invaders. You may also consider taking an over-the-counter medication before you head out for the day. And don’t forget to take a shower. Changing clothes and jumping under the water after being outside can help reduce your exposure to seasonal allergens.
If you’re still not receiving relief from your allergy suffering, talk to your primary care provider, who can help you plan a different treatment approach, which may include an allergist and appropriate prescription medication to curb your symptoms.
If you need relief from seasonal allergy suffering, Southwestern Medical Center can help. To find a provider or schedule an appointment, call 888-796-2362 or visit our find-a-doctor tab here.
SIDEBAR: Is it allergies or COVID-19? It’s a question on many lips during spring and fall, when seasonal allergies are at their highest: are my symptoms “just” allergies or do I have COVID-19? The two ailments unfortunately do have many similar symptoms, but there are some differences. For example, while COVID-19 often results in a fever, allergies do not. Similarly, COVID-19 can often come with muscle aches, while allergies would not. Still, there is enough symptom crossover that - if you are experiencing symptoms and are not sure (and especially if you think you may have been exposed) – the best way to know for sure is to test for COVID-19 with an at-home test or receive a COVID-19 PCR test at a place of care.
April is Limb Loss and Limb Difference Awareness Month, a time to educate the community about limb preservation and emphasize the importance of early evaluation and treatment to prevent amputations.
Of the estimated 150,000 lower limb amputations performed in the U.S. each year, approximately 82 percent stem from a diabetic foot ulcer. When a patient with diabetes fails to keep blood glucose levels under control, a lack of blood flow to the lower limbs can result in the development of ulcerations or open sores. Symptoms include redness, increased warmth or firmness around the wound, swelling, extra drainage, pus or odor.
Some patients with diabetes also develop peripheral neuropathy, or a loss of sensation in the lower limbs and feet. A simple cut or scrape can remain undetected and quickly develop into a severely infected wound. Patients often find themselves in the ER with a systemic infection and need urgent treatment.
It’s important for anyone with diabetes or cardiovascular disease to examine their feet and legs daily. If a wound does not heal on its own within 30 days, the risk of amputation and early death increases. In fact, a recent study shows that lower limb amputations have a three-year mortality risk of 71 percent.
“A chronic diabetic foot ulcer is one of the most common conditions we treat and early evaluation is critical to help avoid limb loss,” said Jennifer James, MD, Center for Wound Healing & Hyperbarics at Southwestern Medical Center. “With proper intervention, most chronic wounds can be healed within four to six weeks and in most cases, amputation can be avoided.”
Wound treatment typically includes debridement, or the removal of dead tissue, management of the infection with the application of advanced wound care dressings or medications, off-loading or taking pressure off the area, and of course, keeping blood glucose levels under control. When a wound still does not respond to standard treatment, hyperbaric oxygen therapy or cellular tissue products (skin substitutes) may be indicated.
It’s important to be proactive and examine the feet and legs every day. Here are four tips for limb preservation, particularly for individuals with diabetes:
Be on the lookout for early warning signs of a diabetic foot ulcer including cuts, sores or blisters on the feet or toes that won’t heal.
Because diabetic neuropathy can prevent you from feeling very hot pavement or other items that could injure the feet, it’s important to not walk around barefoot and wear properly fitted footwear.
Keep the feet clean, moisturized, and covered! Safely trim your toenails and if you have difficulty caring for your own nails, seek help.
Manage blood glucose levels. For diabetics, the best way to prevent foot problems is to keep glucose levels under control. It will also help wounds heal more quickly.
The Center for Wound Healing & Hyperbarics at Southwestern consists of a multidisciplinary team of specialists dedicated to healing wounds, saving limbs, and improving the lives of our patients. For more information or to schedule an appointment, call 580-531-6441.
March is #NationalNutritionMonth, a time when healthcare providers across the country focus on helping patients optimize nutrition for better health. Many individuals battle non-healing wounds stemming from diabetes, cardiovascular disease, or other underlying health issues. Limb loss is a big concern because every day in the U.S. 230 patients with diabetes suffer an amputation. And approximately 85 percent of these cases begin with a diabetic foot ulcer that won’t heal.
Our wound care team is committed to preserving your limbs by healing your wound as quickly as possible. It’s very important to collaborate with them during treatment and nutritional intake is a critical piece of the puzzle. Here are six tips to boost the healing process with a proper diet:
Protein is a major building block in wound healing because it builds muscle, skin, and other body tissues. Eat protein-rich foods including lean meats and seafood, skinless poultry, eggs, and tofu. Yogurt is also a good source but it’s important to check the sugar content.
Vitamin C is often aligned with wound healing because of its role in collagen formation. Consume at least one daily serving of Vitamin C from good sources like oranges, grapefruits, strawberries, broccoli, kale, or red & green peppers.
Stay hydrated by drinking plenty of fluids throughout the day. Water is ideal but if you consume other beverages be mindful of sugar intake.
Eat “good” carbohydrates if you are trying to control your weight. Whole-grain and high-fiber carbohydrates are found in whole grain breads, cereals, brown rice, beans, fruits with skin and berries.
Multivitamins and mineral supplements are sometimes recommended for patients who do not consume an optimal diet or have medical conditions that impact nutritional intake. A supplement can help fill in the gaps. Discuss supplementation with your physician before starting one.
If you need help, consider meeting with a Registered Dietitian (RD) to learn more and create a customized eating plan. Medical nutrition therapy with an RD is covered by most insurance plans as well as Medicare Part B.
Click here for more information about our service or if you would like to speak with someone about a non-healing wound, contact the Center for Wound Healing at Southwestern Medical Center, 580-531-6441.
by Catherine Phipps, PA, Center for Wound Healing & Hyperbarics at Southwestern
Last year, half of the nearly 2 million people diagnosed with cancer in the U.S. underwent radiation therapy to destroy malignant cells. Thanks to new developments in radiation oncology, many patients end treatment and start a new life chapter. However, even though radiotherapy is very good at killing cancer cells, it can also impact nearby healthy cells. Some patients experience delayed radiation injury – painful and occasionally life-threatening side effects that present themselves months or even years later.
Approximately 30,000 of the 2 million U.S. cancer patients treated with radiotherapy last year will eventually report symptoms including significant pain, infection, bleeding, and physical discomfort. Radiation damage can occur just about anywhere on or within the body including the head and neck, chest wall, abdomen or pelvis. For example, patients who receive pelvic radiotherapy for urological cancers may experience significant abdominal pain, urinary frequency or urgency, and blood in the urine. Patients with head or neck cancer can suffer from osteoradionecrosis, a condition in which bone tissue weakens and deteriorates. It is an unusual but serious complication that can result in death of the bone and surrounding tissues and can lead to bone exposure through the skin. Again, these symptoms can appear years after treatment.
The likelihood of radiation damage depends on several factors including a patient’s sensitivity to radiotherapy, the type and dose of treatment, and the location of the cancer. Scarring, infection, and a lack of blood supply to treated areas can result in damage or death of surrounding tissues.
Radiation injury can greatly impact a patient’s quality of life; therefore, finding symptomatic relief is worthy of investigation. For some patients, hyperbaric oxygen therapy can eradicate long-term damage, allowing them to get back to their lives and/or successfully undergo additional reconstructive procedures such as breast or facial surgeries. With limited treatment options for radiation damage, hyperbaric oxygen therapy is a viable non-invasive treatment to consider.
Hyperbaric Oxygen Therapy: Providing Symptom Relief for Patients with Radiation Injury
First used in the U.S. in the early 20th century, hyperbaric oxygen therapy (HBOT) has emerged as a very effective treatment for patients suffering from the late effects of radiotherapy. HBOT can revitalize damaged tissues by bringing nutrients and oxygen to the areas that need it most through the growth of new blood vessels and increased circulation. This stimulates the healing process and can greatly improve the patient’s quality of life.
During treatment, the patient is given 100 percent oxygen in a pressurized hyperbaric chamber. The increased oxygen greatly enhances the ability of white blood cells to kill bacteria and reduce inflammation while allowing new blood vessels to form in affected areas. In other words, it speeds and promotes healing.
Hyperbaric oxygen therapy is very helpful for patients suffering from radiation injury because exposing the body to high levels of oxygen under pressure increases blood flow and vascularization to the area, which promotes healing. Increasing oxygen concentrations in the blood can be a tremendous help for people with radiation damage or chronic wounds. It offers a huge potential benefit with low risk.
How Do You Know if HBOT Treatment Might Help?
If you are a cancer survivor experiencing considerable pain or discomfort months or even years after radiation therapy, consult your physician. If HBOT is indicated, treatment should begin as soon as possible. Most insurance companies will cover HBOT with proper documentation. It should be noted that HBOT is a serious commitment of time and effort on the part of the patient, requiring daily appointments, sometimes for several weeks, for 10-60 treatment sessions. It’s important to note that HBOT is mostly reserved for outpatient treatment. For more information, contact the Center for Wound Healing & Hyperbarics at Southwestern, located at 5606 SW Lee Blvd. in Lawton, by calling 580-531-6441.
Southwestern Medical Center (SWMC) honored Bobby Gordon, the first Wound Care Hero Award recipient from the Center for Wound Healing & Hyperbarics, in a ceremony today at the hospital's Centennial Room.
In November 2020, Mr. Gordon contracted COVID-19 and was hospitalized and placed on a ventilator. His month-long battle to survive left him with painful pressure injuries (also known as bedsores) on several areas on his body. Upon discharge from the hospital, his physician referred him to the Center for Wound Healing & Hyperbarics for outpatient wound care.
“Serious pressure injuries require a significant commitment to treatment, on the part of the patient, to avoid infection, sepsis, and possible limb loss,” said Catherine Yore, PA-C and wound care expert. “Mr. Gordon’s wounds were quite severe and he has been seeing us every single week for almost a year. He’s been a model patient and his family has been very helpful with dressing and monitoring the wounds at home. He consistently enters our clinic with a cheerful greeting and positive attitude.”
Because of his extraordinary and inspirational commitment to healing, Mr. Gordon was honored with the Wound Care Hero Award. The award is sponsored by Wound Care Advantage and recipients are selected based on their commitment to treatment and positive attitude.
“I wouldn’t wish my experience with COVID-19 on anyone, and for a while I didn’t know if I was going to make it,” said Mr. Gordon. “I’m so appreciative to the wound care team at Southwestern Medical Center because they have been so respectful, caring and professional. They took really great care of me.”
“Our entire staff has enjoyed getting to know Mr. Gordon and his family and he’s almost ready for discharge,” said Yore. “We want his wounds to heal so he can be as close to his previous status as possible, but we’re also going to miss him when he ends treatment!”
August can be brutally hot, and even when the sun goes down things like sand, pavement, concrete, and even that fancy cool-deck can still be holding the day’s trapped heat. So, before kicking off your party shoes after sunset, consider how hot it was that day. Anything that is above 
When it comes to the process of looking at the foot for any sign of a new wound developing, remember SUMMER: