Page 18 - Christiana Care Health System Focus September 2018

Surgical Services | Healingwounds CONTINUED
A team approach to care
Many patients are referred to the center
by their doctor or a specialist. However, patients do not need a referral to seek treat- ment; the team will contact the patient’s primary physician for the necessary infor- mation. Christiana Care has also reached out to urgent care centers to make it easier for them to refer patients.
Regardless of how they hear about the program, patients can often get an appointment at the wound care center the day after calling.
A multidisciplinary team of wound care experts takes a comprehensive approach to each patient. “You need to put all the pieces together,” said Dr. Mast, a certified wound care specialist who is board-certified in internal medicine and geriatric medicine.
Lesa Prichard, BSN, RN, the nurse manager of the Wound Care and Hyperbaric Medicine Center, agrees.
“From the moment a patient calls the center, their care is already beginning,” Prichard said. “We do a thorough patient intake query and ask a lot of questions. We want to match them with the best possible
Cproviders to initiate their care.”
reating a treatment plan may require input from infectious disease specialists, nurses certified in wound care,
podiatrists, general surgeons, plastic surgeons and vascular surgeons.
Every patient receives a nutritional assessment. “It’s essential to wound healing,” Dr. Mast said of a good diet.
Because the Wound Care Center is part
of Christiana Care, patients can have
all the necessary diagnostic studies and evaluations completed within one system.
Advanced treatments for wound care
An individual's treatment plan depends on the type of wound. “We have specialty treatments that aren’t available in most physician offices,” Dr. Mast said.
That includes state-of-the-art hyperbaric oxygen therapy (HBOT). Indications for HBOT include ulcers, pain or bleeding as
a result of previous radiation therapy, dia- betic foot ulcers, bone infections and ulcers due to poor circulation.
"It's important to realize that HBOT can effectively treat these conditions,” Prichard said. “It can often help patients who are suffering or who are at risk of losing a limb.”
Christiana Care currently has two HBOT monochambers. Patients comfortably lie down in the chamber, which circulates 100 percent oxygen. The atmospheric pressure is increased and controlled. The body takes in the pure oxygen and delivers it to areas where the blood circulation is blocked or diminished to promote healing, reduce swelling and kill bacteria.
The glass chambers are enclosed, but patients are able to see their full surround- ings. Christiana Care’s two chambers are located in a corner room with plenty of windows. Each chamber has a TV. “I just focused on the television, started watching a movie and went to sleep,” Foster said.
Patients undergo HBOT for 30 to 40 days, Monday through Friday. Each treatment is from 90 to 120 minutes. From physicians to nurses to clinical technicians, only staff trained in hyperbaric medicine administer the treatment.
Not every patient needs HBOT. Other treat- ments at the center include advanced dress- ings, compression wraps and debridement.
Negative pressure wound therapy involves
the use of a vacuum dressing to promote wound healing. Other treatments may include bioengineered skin substitutes that contain growth factors to encourage new skin growth.
The center will coordinate any external services, such as ordering medical supplies for the home, coordinating clinical studies or arranging home health care.
Increasing services, ensuring quality
This fall, the center will add another HBOT chamber to better accommodate patients who weigh up to 700 pounds or are up to 7 feet 5 inches tall. The new equipment is just one example of how the Wound Care and Hyperbaric Medicine Center is expanding its services.
C
need treatment and to facilitate
hristiana Care is also developing a lower-leg wound pathway to identify and help patients who
comprehensive care. For example, a patient might come to the hospital with congestive heart failure but also have a leg wound. With the pathway in place, the patient will receive follow-up care for both, not just
for the heart failure. The multidisciplinary project involves specialists in the wound care center, vascular surgery, interventional radiology, lymphedema therapists, podi- atry, home health care and acute surgical services, as well as wound ostomy and continence nurses.
Foster is grateful for the center’s resources. “Everything,” she said, “is going just fine.” 
16 CHRISTIANA CARE HEALTH SYSTEM
A multidisciplinary team of wound care experts takes a comprehensive approach to each patient at the Wound Care and Hyperbaric Medicine Center.