Advanced wound care is a lot more than just changing bandages. The staff at the Augusta Health Wound Healing Clinic are “wound detectives” trying to get to the root of the problem.
“We don’t treat just the wound, but everything that causes that wound,” said Dianne Moody, MSN, RN, the director of the Wound Healing Clinic, which opened in 2009 as Augusta Health’s response to a growing need that had been identified by doctors and nurses.
Dr. Joseph Ranzini joined the clinic in January. Dr. Ranzini is joining Dr. David Caulkins in the Wound Healing Clinic. Dr. Caulkins has been the Medical Director of the clinic for three years.
Under Caulkin’s leadership, the clinic has experienced significant growth and the addition of hyperbaric oxygen therapy in 2013.
The cases that the team sees can vary – peripheral vascular disease, diabetes, infections, cancer and the side effects of radiation therapy.
“We’ve seen paraplegics and quadriplegics who have pressure ulcers. We see elderly people who are confused and demented, can’t care for themselves. We’ve seen folks who really just need somebody to care for them, take them seriously, try to help heal their wounds, and help them get on with their lives,” Ranzini said.
Most common are ulcers on legs due to poor circulation, ulcers on feet from diabetes, pressure ulcers because of being chair- or bed-bound, that can be debilitating if not treated, and can lead to death if they become infected and get into bone.
Moody remembers one case involving a man in his 30s who found himself at the clinic after getting a grim prognosis from his doctor: when you are ready to have your leg amputated, his doctor had told him, give me a call.
“That was a life-changing moment for him,” Moody said.
In the case of the patient facing leg amputation, it was a combination of obesity and diabetes that were the threats to his long-term health and well-being.
It’s Moody who coined the term “wound detectives” to describe the efforts of staff to try to help patients get in the direction of healing.
“One day one of our docs got down literally on the floor and watched the patient walk up the hallway because he could not figure out how this was happening. The patient was hitting their foot on their walker with every step they took,” Moody said.
“As wound detectives, you’re looking at why they have this wound, because normal people should be able to heal a wound. Is it that their diabetes is out of control, is it the type of chair they’re sitting in, is it the kind of shoe they’re wearing? We don’t just take care of that wound. We try to get to the bottom of the cause of the wound,” Moody said.
There are many different phases of wound healing from the time the injury first occurs until the final skin covers over the area, Ranzini said.
“Wounds, unfortunately, can get stalled in a chronic non-healing fashion for a variety of reasons,” Ranzini said.
One of the principal reasons, Ranzini said, is that the body, with the surface bacteria that we’re all surrounded by in our world, creates something called biofilm that traps fiber debris and bacteria in a matrix that sometimes the body just can’t close up and seal over.
The approach to dealing with wounds at this stage is to scrape the wound, cut off dead tissue, and use advanced dressings to help begin the healing process.
“The goal is to freshen it up and try to restart, or jumpstart, the wound healing process so that proper healing can then occur,” Ranzini said.
The healing process requires patience and commitment on the part of patients, but the reward at the end of the process is very much worth the effort.
“One of our early patients had had his wound for 11 years, and we healed his wound in nine months. We achieved this by seeing the patient two to three times a week and providing an evidence-based wound care treatment plan. He was able to return to work when he thought he was going to have to be out on disability,” Moody said
The patient who was facing leg amputation had a happy ending to his story as well.
“We saved his leg, and that was so rewarding,” Moody said. “Statistics show that once a patient has an amputation, often they decline even further, their quality of life is impacted, they don’t go back to work. This guy committed to wanting to save his leg, and we partner with the patient to meet the goals of wound healing.”
Quality of life is the ultimate goal.
“The goal is to keep patients out of the hospital,” Moody said. “Our clinic’s goal is to partner and do whatever we can to keep patients out of the hospital so they can live in their home, even though patients sometimes have these wounds for six months, maybe a year or two.”
The work can be “challenging,” Ranzini said, but the reward is seeing the difference in lifestyle for patients.
“They’re challenging in some ways, but they’re also very, very grateful,” Ranzini said. “Because they know that somebody, after potentially dealing with a problem for months or even years, in some situations, are listening to them, helping them, trying to care for them in a way that is compassionate, and hopefully going to go on to help them heal.”
Augusta Health Wound Healing Clinic
Types of Wounds Treated
- Diabetic Ulcers
- Pressure Ulcers
- Arterial Ulcers
- Venous Ulcer
- Trauma
- Cellulitis
- Radiation therapy wounds
- Any wound that has not healed in 1 month
Chronic wounds heal faster by treating the cause of the non-healing wound and applying evidence-based, medical and surgical techniques that are outcome focused and cost-effective.
Treatment Methods
- Hyperbaric Oxygen Therapy
- Advanced wound dressings
- Vacuum Assisted Closure
- Bioengineered Tissue
- Debridement
- Wraps to decrease lower leg swelling
Patients and their families or caregivers are also taught how to care for their wounds at home to further facilitate faster and more permanent healing. The latest approved devices and dressings to promote healing are used. The Wound Healing Clinic also coordinates consultations and treatments for in-patients with chronic, non-healing wounds.
Contact information
78 Medical Center Drive
Fishersville, VA 22939
(540) 245-7230
(540) 221-7230
Follow signs to the Cancer Center building. Enter the lobby and take the elevator to the 2nd floor. The Wound Healing Clinic is located to the right when you exit the elevator.
Share
Contributors
