Wound Care

Who Should See a Wound Care Specialist?

Minor skin wounds are common and often heal on their own. But if your wound is large or deep, or it doesn’t get better with home treatment, you may need professional care. When left untreated, open wounds can become infected — increasing your risk of complications such as amputation, sepsis or organ failure.

Fortunately, expert wound care is available right here in central Virginia. Our providers have leading-edge training in therapies for difficult-to-heal wounds. We treat serious and chronic wounds caused by all types of injuries and illnesses. These include:

• Bedsores (also known as pressure injuries)
• Burns
• Compromised skin flaps and grafts
• Diabetic wounds
• Ischemic ulcers caused by poor blood flow through the arteries
• Neuropathic ulcers
• Osteomyelitis (bone infection)
• Radionecrosis (skin or bone damage caused by radiation treatments)
• Soft-tissue infections, including cellulitis and necrotizing fasciitis
• Surgical incisions that won’t heal or become infected
• Traumatic injuries, such as crush injuries, puncture wounds, and animal bites
• Venous ulcers caused by poor blood flow through the veins

Many wounds are caused by vascular (blood vessel) problems. For example, peripheral artery disease often causes ischemic ulcers, while chronic venous insufficiency can lead to venous ulcers. To that end, our wound care specialists work closely with vein and vascular specialists at the Centra Heart & Vascular Institute. This ensures you receive complete care for both your wound and the underlying condition that caused it.

Our Comprehensive Wound Care Services

We aim to heal your wound as quickly as possible and prevent new ones from occurring.

Wound Assessment

Proper wound care begins with a thorough assessment. Our approach depends on whether your wound is visible or deep under the skin’s surface. Your evaluation may include:

• Comprehensive wound assessment. We document the size and severity of your wound using digital photos. For tracking purposes, we’ll take pictures of the wound at each visit.
• Lab tests. We may swab your wound to see if it contains bacteria, order comprehensive labs or check your blood sugar to see if you have prediabetes or Type 2 diabetes.
• Imaging services. We use noninvasive tests to look for damage to internal tissues or bone or to check for problems with blood flow. These procedures include ankle-brachial index tests, ultrasound, MRI, and bone scans.
• Oxygen perfusion assessment. We place a noninvasive sensor on your body to see if there is adequate blood flow to your wound. This is important because blood carries oxygen — and oxygen is vital to wound healing.

We also offer nutrition assessments and education to patients who are interested in improving their diet. We can teach you which foods promote faster healing — and also reduce your risk of medical problems that cause wounds in the first place.

Wound Treatments

Following your assessment, we’ll create a personalized treatment plan that may include one or more of the following therapies:

• Antibiotic management. We use different types of antibiotics to prevent or treat infections. These include topical creams, oral tablets and IV therapy.
• Bio-engineered alternative tissue. Biologic or synthetic material placed on the wound promotes quick healing.
• Compression therapy. Special stockings or compression bandages worn on the legs help improve blood flow in the veins. Increased blood flow can speed wound healing.
• Debridement. We carefully remove any dead or infected tissue from inside or around the wound.
• Growth factor therapy. We use topical creams containing special biologic proteins that speed up the wound healing process.
• Hyperbaric oxygen therapy. We use a large machine called a hyperbaric oxygen chamber to increase the amount of oxygen in your bloodstream. Oxygen fights bacteria and promotes healing in infected skin or bone.
• Total contact cast. We use a special cast to help protect and heal diabetic foot ulcers. Unlike casts used to set broken bones, these casts are replaced every week or two for about eight weeks, or until your ulcer heals.
• Vacuum assisted closure (wound VAC). We use a machine called a vacuum pump to decrease air pressure around the wound. This causes the edges of the wound to pull together and heal faster.

Our wound care specialists will teach you how to care for your wound at home. For your convenience, we can also mail wound care supplies directly to your home or work with your home health agency.

A Team Approach to Treatment

Certain medical conditions can cause your wound or prevent it from healing properly. To lower your risk of developing more wounds, we work closely with other Centra specialists who can help address all your medical needs.

Our integrated team includes:

• Cardiologists who treat high blood pressure and high cholesterol, conditions that can make it harder for wounds to heal
• Endocrinologists who can help you get your Type 2 diabetes under control, lowering your risk of diabetic foot ulcers and Charcot's foot
• Vascular surgeons who treat peripheral artery disease, a major cause of ischemic ulcers
• Vein and vascular specialists who care for varicose veins, chronic venous insufficiency, and other conditions that cause venous ulcers
• Surgical and nonsurgical weight loss specialists can help you achieve a healthy weight. Too much weight slows the wound healing process and puts you at risk for diabetes and other conditions that cause skin ulcers

Ostomy Clinic

We believe that all people who undergo ostomy surgery should have access to a specialized ostomy provider to help with adaptation and adjustments that are necessary following surgery and on an ongoing basis. All patients with an ostomy should be evaluated annually by a certified ostomy provider to identify issues before they arise. Patients will receive comprehensive ostomy care from a board-certified nurse practitioner who has not only received specialized training in ostomy and wound care, but also has personal experience living with an ostomy.

SERVICES

In addition to clinical assessments and treatments, our ostomy care team provides:

• Presurgical ostomy site marking
• Presurgical education: Patients will receive information regarding their specific type of ostomy and how to care for it. Patients will learn about pouching, as well as diet and lifestyle changes.
• Local hospital care: Patients will be assessed by certified ostomy nurses, as well as our certified nurse practitioner while in the local hospital following their surgery and will receive home instructions, hands-on training and education.
• Postsurgical care: Patients will receive written home instructions, educational materials, and information on how to obtain supplies, including a description of the various pouching systems currently available.
• Appliance fitting and adjustments: We offer assistance with difficult stomas. The goal is to maximize pouch wear time.
• Peri-stomal wound management: We offer assistance with the management and treatment of wounds that are located near the stoma, which includes maximized pouch wear time.