Healing Ulcers at a Wound Care Center
The ACFAS (American College of Foot and Ankle Surgeons) claims that the risk of getting a foot ulcer is a 15% possibility for diabetics. As a result of a loss in feeling at the bottom of diabetics’ feet which is due to a complication of their diabetes known as sensory neuropathy, ulcers and cuts can occur. This complication with its lack of protective feeling puts the feet at risk to pressure or trauma which can lead to harm. Peripheral vascular disease, the narrowing of blood vessels at the extremities of the human body, is another diabetes complication which can cause foot ulcers. Peripheral vascular disease with its narrowed blood vessels and lessened blood flow, reduces the oxygen as well as nutrient supply to the feet, resulting in poor healing of the cuts received by the feet.
Without proper attention to ulcers, infections can worsen and lead to amputations of the lower-limb. So, the best way to treat a foot ulcer is to have it given the immediate and proper treatment to prevent more complications. The right treatment to avoid complications can be available at a wound care center which can give specialized treatment. It has been proved by multiple scientific studies that a health care team which comprises of doctors specialized in different fields is able to provide better treatment of diabetic foot ulcers. Such wound care centers have the different types of specialists available to provide the latest wound care therapies, at least one of which may be effective in the treatment of your wound.
From the 1980s, throughout the United States, the number of wound care centers has increased. At the beginning, these centers merely specialized on one particular kind of treatment and did not provide a wide choice of complete treatments. Fortunately, with more wound care technologies and products available, a greater range of specialists from different disciplines are more accessible at wound care centers. These doctors from the various disciplines work together as a team to achieve better success rate. With the huge number of patients with the same problems at these centers, the doctors at these centers also develop their healing capability. An average 80 percent healing rate is possible with a 16-week period of treatment at such a specialized center for wound healing.
Should you be sent to one of the wound care centers to have a foot ulcer or some kind of wounds, it would be beneficial to know about the people at such centers, the treatments available as well as the educational choices at such centers. The aim of this article is to provide information on the work done at such centers and the various types of the latest methods of treatment available for foot ulcers suffered by diabetics.
Diabetic Foot Examination -Video Guide
What to expect at a wound care center
The majority of wound care centers are found inside or very close to hospitals catering to serious health problems. Usually, the center is under the administration of the hospital. There are some which the hospitals have contracted a company to manage. A group of doctors, working half a day, are usually available at the hospital. Each doctor is a specialist in his own field. Some of the specialists found at a wound treatment center are those concerned with primary care, orthopedic, surgery, podiatric as well as internal medicine. All these specialists are expected to get training in wound therapy. Such training may be in the form of seminars and workshops. For centers run by corporate bodies, the specialists are to take part in certified programs on wound care. At present, there is an examination by the AAWM (American Academy of Wound Management) for healthcare providers.The Certified Wound Specialist (C.W.S.) title is awarded upon clinicians who completes the examination successfully. However, there is, at present, no record of certification of these doctors by a formal board.
Besides the specialist doctors, there are other types of healthcare professionals. Many have nurses with certified abilities having qualifications like :
- Certified Wound Care Nurse (CWCN),
- Certified Wound, Ostomy, and Continence Nurse (CWOCN), or
- Certified Wound Ostomy Nurse (CWON)
Such qualifications are given to nurses upon completion of certain coursework or have gained vast experience in dealing with wounds through a specified time in wound therapy.
The rest of the professionals on the wound care team may comprise of:
- Dietitians; and doctors from different types of specialties
- Diabetes educators
- Medical technicians, those who are specialist in particular diagnostic methods or treatments (like a CHT, or Certified Hyperbaric Technologist)
- Physical therapists, who uses certain exercises to assist a person to perform his usual activities while the wound gets treated.
- Orthotists, the people who deal with braces, splints, as well as special footwear.
On the first day, you are expected to give a complete medical background and undergo a physical examination when you go to a wound care center to seek treatment. The doctor who attends to you would have to know whether you have ever had a surgery, the type of surgery, the medications taken, as well as any health problems you are suffering from in order to make the right wound diagnosis. Therefore, have all the information ready for your first session with the doctor.
A vascular test may be made at this first visit. The vascular test may be just a feel of your pulse or a Doppler examination which involves the use of sound waves to get signals which can be heard; signals which are linked to the flow of blood in your veins and arteries. Both feet will have to be examined on this first visit as well as on future visits to the center. In fact, you should insist that the doctor examine your feet. Ask the doctor to test for sensory neuropathy by having the bottom of both your feet subjected to some kind of sensory test. You are considered to have protective sensation loss if any part of the bottom of your feet is unable to feel pressure caused by a 10-gram single nylon fiber used in sensory testing. Such loss of sensation can lead to a foot ulcer and therefore needs specially made shoe inserts to reduce such a possibility. However, shoe inserts alone are insufficient protection if they suffer from serious neuropathy with much deformities of the feet; making it necessary to wear custom-made shoes molded to fit the deformed feet. It is usually in this kind of foot examination that the diabetic gets to realize that he has sensory neuropathy.
Next, you will be given tests at the lab as well as x-rays. When the wound care team has gathered all the necessary information, a certain dressing will be chosen to treat your wound. You, perhaps your caretaker as well, will be given instructions on the correct dressing methods to be used at home. Normally, wound-healing methods which keep the wound moist all the time are used. The old method of letting air dry up the wound has been found to be not the best method as having the wound too dry can result in slow healing. .
Besides wound treatment, a wound care clinic ought to make available educational resources as well as professionals to attend to any need for further information. Pamphlets or booklets on the correct nutrition, foot care, wound treatments, and possible signs of the situation worsening. The ADA (American Diabetes Association), the ACFAS (American College of Foot and Ankle Surgeons), and the WHS (Wound Healing Society) do make available pamphlets or booklets containing guidelines for diabetic foot care. Do ask for them when you are at such a wound care clinic.
With about three weeks of the right treatment at a wound care clinic, much improvement of the wound ought to be noticed. Such improvement can be in the diminishing size of the wound or the difference of the tissues in the wound with most of the yellowish mush drying up to show firm, red tissues which is a clear indication of healing. As it is a well-known fact that high levels of blood sugar slows down healing, the clinicians attending to you should be assessing your blood glucose control. At the same time, a diabetes educator or a dietition may have a talk with you to assist you in finding ways to control diabetes better. Since such control over blood glucose is important to the healing of your wounds, the diabetes educator is important to the whole program on wound care.
After the wound is healed, there is still the need to prevent future occurrences of ulcers on the feet, especially for those who suffer from diabetic wounds before. There is a continuous need for care and effort to prevent getting an ulcer again. There may be a need for inserts or customized shoes. Such shoe inserts can last for about four months, the period actually depending upon the material used, the weight of the wearer, and the distance covered by the shoes. You ought to have a professional examine your customized shoes at least once a year. During every visit to your doctor, make sure you are barefooted when the doctor arrives to get your doctor to look for deformities of your feet, any signs of ulcers and the formation of callus that can result in ulcers as well as to examine the bottom of your feet for its ability to feel.
Ulcers on the feet of a diabetic is considered a serious problem which can cost a lot of money for treatment and can have the person become an invalid. The possibility of you overcoming this problem is greater if treatment is obtained from a wound-care team comprising of the best suitable professionals for the problem. To increase the chances of success, you must also be involved in the therapy. Have copies of all the necessary medical records as well as results of connected lab tests with you on the first day to the clinic. Go to the internet or the library and refresh as well as add to your knowledge on diabetic foot care. The more you ask, the more you will be told, the more understanding of the situation you will get and the better you will be at participating in the wound care team. This, together with the latest products and treatment strategies, will certainly help to heal your foot ulcers.