The LKMC Wound Care Treatment Program serves patients from infant to geriatric, and is available to all LKMC staff physicians for wound care procedures consisting of, but not limited to:
- Diabetic Neuropathic Ulcerations
- Chronic Venous Insufficiency
- Arterial Insufficiency Wounds
- Non-Healing Pressure Ulcers
- Acute Skin Reactions to Radiation Therapy
- Infected Wounds
- Non-Healing Surgical Wounds
Procedures consist of, but are not limited to:
- Wound Debridement
- Compression Therapy
- Ostomy Related Procedures
Medical Director, Dr. Michael Derouin and Nurse Assistant, Cheryl Gegoric see patients in a wound care clinic from 8:30 a.m. to 12 Noon Tuesdays and Fridays. The team is also available for acute care consults within the hospital.
Statistically, the most common diabetic complication leading to hospitalization is foot disease. Why? Because diabetes usually leads to circulatory problems and nerve damage leading to “loss of protective threshold”— in other words, loss of the ability to feel or sense irritation to the feet. The irritation might be a pebble in the shoe, or a cut or nick on the bottom of the foot, or even a sliver of glass, embedded in it. A simple ingrown toenail can quickly grow into a major infection for a diabetic.
If a person cannot sense that there is a problem, because they cannot feel pain the way a person with normal circulation does, they may unknowingly allow the irritation, and ensuing infection, to continue. When blood flow is compromised, healing oxygen and nutrients are not being supplied to the tissues of the feet. In diabetics, healing is slow, and bacterial infection can often proliferate faster than the diabetic’s body can defend against the assault. Peripheral neuropathy is the most important factor leading to amputation in people with diabetes. And diabetics are at much greater risk for amputation than the general population.
Dr. Derouin, a podiatrist and specialist in wound care, explains that healing wounds of the feet is just the first part of what the wound care team does. Thanks to a number of new and sophisticated antibiotics and medications, doctors have good success in healing the foot wounds of diabetics.
Venous insufficiency, or a lessening of the ability of the veins to return blood from the feet back to the heart, puts some people (non-diabetics) at risk for open sores in the lower legs. Sometimes vein problems are only cosmetic, but they can cause blood clots or tissue damage. When blood is not circulating properly, it may pool in the ankles. Fluid may leak into surrounding tissues, causing swelling. At this point tissue is susceptible to breaking down and forming an ulcer, particularly when the skin is bumped or scratched. Compromised blood flow may prevent proper healing and a chronic sore or infection may ensue.
That’s where the wound care program comes in. Ulcers need frequent medical care. Special dressings may be used to absorb drainage, while keeping the ulcer moist. Antibiotics may be needed to fight infection. To help reduce swelling, pressure may be applied to the affected site. Again, patient education is an important part of the job of treating wounds. There are a number of things people with chronic venous insufficiency can do to prevent further problems.
Spider bites, moped abrasions and pressure or “bed” sores are other sources of wounds requiring special care. Spider bites, which can only be diagnosed for certain when actually witnessed, can create terrible skin ulcers. The wounds that come from skidding on the pavement, after falling off a moped or motorcycle, are common in Key West. They can turn very nasty without proper treatment.
People confined to a chair or bed, or people with partial or total paralysis, are prone to developing pressure ulcers. Normally, our nerves signal us to shift our weight or change sitting or sleeping positions frequently, without our even noticing. However, illness or injury can reduce these natural actions. Sores like these also need special attention from wound care experts.
If you feel that you need special medical help with a sore or wound, ask your doctor for a referral to the LKMC Wound Care Program, or, call the LKMC Wound Care Program directly at: 305-294-5531, Ext. 4734 for more information.