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FirstHealth of the Carolinas
FirstHealth Wound Care Centers By Judy Morganthall

People who have chronic sores or wounds that won’t heal will soon be able to receive specialized treatment at outpatient Wound Care Centers at two FirstHealth hospitals.

Moore Regional Hospital in Pinehurst and Richmond Memorial in Rockingham will offer wound care services that are not available in most physician offices or community hospitals. Wound care programs have just begun accepting patients at Richmond Memorial while Moore Regional’s program will open later this spring.

Patients with uncontrolled diabetes are particularly susceptible to chronic sores. Diabetes can cause poor circulation and nerve damage, especially in the feet and lower legs, which can lead to hard-to-treat sores. These can become infected if not properly treated and, in the most serious cases, can result in amputation.

About 82,000 lower-limb amputations were performed on people with diabetes in 2002, according to the U.S. Centers for Disease Control and Prevention.

Decubitis ulcers, also known as bedsores or pressure sores, are another common type of chronic wound. These sores can develop when someone spends most of the time sitting or lying in one position. This reduces blood flow to the skin in a particular area, producing pressure sores, which are especially slow to heal.

Patients with peripheral vascular disease, kidney failure or circulation problems related to other conditions are also more likely to develop chronic wounds. And, with some patients, surgical incisions don’t heal as fast as they should.

Oxygen therapy
The Wound Care Centers at Moore Regional and Richmond Memorial will eventually have two hyperbaric chambers for delivering high-dose oxygen therapy, which promotes the healing of some chronic wounds.

The patient lies comfortably in the hyperbaric chamber as the air pressure is gradually increased. High concentrations of oxygen can stop certain types of infections and help wounds heal by stimulating cell growth and increasing blood flow to the wound.

Hyperbaric oxygen is expected to be used for up to 15 percent of patients treated at the FirstHealth Wound Care Centers.

Wound cleaning and treatment
All three FirstHealth Wound Care Centers will specialize in cleaning and treating wounds with state-of-the-art products and technologies and then closely monitor patient recovery.

The first step in wound treatment, called debridement, involves removing dead skin and cleaning the wound. This restores blood flow to the area and allows the wound to heal from the inside out.

Debridement can be done with enzymes, gels, irrigation or whirlpool therapy. The wound is then treated with such advanced wound care products as bioengineered tissue and silver-impregnated dressings.

Wounds can take a long time to heal, especially if they are the result of chronic medical conditions such as diabetes or vascular disease. They can sometimes partially heal and then reopen. They may never fully heal if the underlying cause is not effectively treated, and even with the best medical care, wound healing can be a slow process.

“It’s not just one or two visits,” says Leslie Salloum, M.D., a general surgeon and medical director of the Wound Care Center at Richmond Memorial. “It can take from a few weeks to six months for wounds to heal.”

Because of that, it is especially important that expert wound care is now available locally. Previously, patients sometimes had to be referred to one of the state’s university medical centers for treatment.

Leslie Salloum, M.D.

David Strom, M.D.

“That was really inconvenient for a lot of people,” says David Strom, M.D., an orthopaedic surgeon and director of the Moore Regional Wound Care Center. “These patients often need to be seen every week, and it isn’t practical for them to travel a long way to an appointment.”

According to Dr. Salloum, a big advantage of having a facility that focuses on wound care is that its physicians, nurses and technicians focus on treating patients with similar medical needs. The FirstHealth Wound Care Centers provide a resource for general surgeons, orthopaedic surgeons, vascular surgeons, podiatrists, wound care specialists and others to collaborate on the best and most comprehensive treatment.

It is not uncommon for patients with wounds—whether they are foot sores or bedsores—to wait several months before seeking treatment, hoping the wounds will heal on their own.

“If we can speed the healing along, they can get up in a chair easier, they can walk easier and they can have a better quality of life,” Dr. Strom says.

FirstHealth has contracted with Medical Multiplex Inc. (MMI) of Louisville, Ky., to manage its wound care programs. The company has specialized in chronic wound treatment since 1994 and currently works with a number of hospital systems around the country, including programs in Chicago, Dallas and Indianapolis.

Roberto Penne, M.D., MMI’s chief medical officer, is the retired commander of the U.S. Air Force’s Hyperbaric and Wound Care Medicine Flight. He is fellowship-trained in hyperbaric medicine and directed the Air Force’s Hyperbaric Fellowship Program.