Why Wound Care Research Matters—For Everyone

WoundCentrics providers take care of patients with complex, chronic wounds; challenging conditions that are among the hardest medical conditions to treat. But we don’t just treat complex wounds; we also do something very important for the future of medicine: research. WoundCentrics participates in multiple, FDA-registered Randomized Clinical Trials, which means we follow strict guidelines to study new treatments for wounds, to generate the highest-quality medical evidence. 

This research helps patients today—and will help many more in the future. Our dedicated research resources include multiple clinical and non-clinical personnel, who assure patient safety, review protocols to find those most compatible with our patients' needs, assure that those protocols are followed closely, and make certain that all scientific data is captured and recorded securely.

Helping Patients Right Now

When patients join a research study, they often get access to advanced treatments that aren’t yet widely available. These may include new wound dressings, medications, or even cutting-edge technologies. Patients in research studies are also watched very closely by our team. We take extra time to monitor their progress, make adjustments when needed, and collect important information that helps us understand what works best. Many patients feel reassured knowing they are getting this kind of detailed care.

But even patients who aren’t part of a research study benefit, too. Why? Because being a research organization means we are always practicing at the highest level. We use proven methods, follow the latest scientific guidelines, and carefully track how our patients do over time. This creates a culture of excellence, where every patient—whether in a study or not—gets thoughtful, expert care.

Doing the Right Thing for Our Field

Being involved in research also means we are helping lead the way in wound care. We believe that taking care of today’s patients is important—but so is looking ahead. That’s why we see our research work as a form of stewardship. Stewardship means taking responsibility for something valuable. In this case, it means helping our whole field grow stronger by contributing to the science behind what we do.

Our research helps doctors and nurses everywhere understand wounds better and treat them more effectively. We publish our findings, work with other scientists, and support the development of treatments that could change lives. That’s good not only for our patients, but for people across the country—and even around the world—who may one day benefit from the things we’ve learned.

From breakthrough imaging technology, allowing clinicians to literally see blood flow inside the skin, to new fiber-based artificial skin technologies, our team is doing our best to improve the patient experience for those who suffer from chronic, non-healing wounds.

A Brighter Future for Medicine

When medical groups like ours do research, we’re not just helping individuals. We’re improving the whole system. Science moves forward one step at a time, and every patient who joins a study is part of that journey. Every new idea we test could lead to safer, faster, and better healing for people with wounds.

At the end of the day, wound care research is about hope. It’s about working together to find answers, solve problems, and give every patient the best possible chance to heal. Whether someone is part of a study or not, they’re part of something bigger—a medical team that is always learning, always improving, and always caring.

And that’s something we can all feel good about.

Revolutionizing Wound Care: UltraMIST Therapy at WoundCentrics Clinics

In the ever-evolving landscape of wound care, advanced technologies are continually enhancing treatment options for patients. Among these innovations is UltraMIST therapy, a groundbreaking approach utilized at WoundCentrics clinics. This therapy has revolutionized wound care by offering a non-invasive, effective solution for promoting faster healing and improving patient outcomes.  UltraMIST therapy is a cutting-edge treatment that harnesses the power of low-frequency ultrasound to enhance tissue repair and stimulate healing. Unlike traditional ultrasound treatments, UltraMIST therapy is non-contact, making it an ideal option for patients with sensitive or painful wounds. By delivering ultrasonic energy below the wound surface, it triggers cellular activity and jumpstarts the body's natural healing processes. 

The effectiveness of UltraMIST therapy lies in its ability to stimulate cellular regeneration, improve blood flow to the wound area, and reduce inflammation, which are key factors in enhancing wound healing. This therapy has shown remarkable results, especially for chronic wounds such as diabetic ulcers, venous leg ulcers, and pressure ulcers that have been resistant to conventional treatment methods. 

WoundCentrics has embraced cutting-edge technologies like UltraMIST therapy as a core component of their advanced wound care offerings. With a team of highly trained wound care specialists, WoundCentrics ensures that patients receive the most effective treatments available. Providers at WoundCentrics clinics undergo specialized education in advanced wound care techniques, including the utilization of UltraMIST therapy, demonstrating their expertise in delivering holistic care. 

Studies have shown that UltraMIST therapy at WoundCentrics clinics leads to reduced healing times, decreased wound size, and lower infection rates. Patients who have undergone UltraMIST therapy report experiencing less pain and greater satisfaction with their care, showcasing the positive impact of this innovative treatment approach. 

At WoundCentrics clinics, patients receive comprehensive, personalized care plans that incorporate UltraMIST therapy alongside other modalities for a holistic approach to wound healing. By integrating UltraMIST therapy with other advanced treatments, WoundCentrics addresses the complex nature of chronic wounds and aims to prevent the need for more invasive procedures. 

WoundCentrics' commitment to innovation is evident in their continuous integration of state-of-the-art technologies like UltraMIST therapy into their clinics. Providers at WoundCentrics undergo rigorous training to stay abreast of the latest advancements in wound care, ensuring that patients receive the highest standard of care possible. 

In conclusion, UltraMIST therapy at WoundCentrics clinics represents a significant advancement in wound care, offering patients a non-invasive, effective solution for promoting faster healing and improving outcomes. Individuals with chronic wounds can benefit from seeking comprehensive care at WoundCentrics clinics, including UltraMIST therapy, to access cutting-edge treatment options that enhance healing and quality of life. 

The Life-Altering Effects of Living with Chronic Diabetic Foot Ulcer

Living with diabetes presents numerous challenges, but one of the most debilitating complications is the development of chronic diabetic foot ulcers (DFUs). These non-healing wounds not only pose significant health risks but also severely impede a patient's quality of life, limiting their ability to remain active, independent, and fully engaged in daily activities. The impact of DFUs extends beyond physical limitations, affecting emotional well-being, social interactions, and even financial stability.

Chronic diabetic foot ulcers drastically affect a patient’s ability to lead a full, active life. These ulcers are not just painful; they can limit mobility, making it difficult to perform routine activities such as walking, exercising, or even standing for long periods. Many patients must limit their physical activity, which can lead to a sedentary lifestyle that exacerbates other health issues such as obesity, cardiovascular disease, and poor mental health.

Living with a chronic diabetic foot ulcer can be emotionally draining. The prolonged nature of the condition often leads to feelings of frustration, anxiety, and depression. Many patients feel a sense of hopelessness, particularly when faced with slow healing and recurrent infections. The constant worry about potential complications, such as amputation, can lead to significant mental health challenges.

A study published in Diabetic Medicine found that 50% of patients with DFUs experience significant emotional distress, with higher rates of anxiety and depression compared to the general population. The fear of losing mobility or independence due to worsening ulcers can further compound this distress, creating a vicious cycle where emotional health worsens, which in turn negatively affects physical health.

DFUs can also have profound effects on social interactions and relationships. Many patients feel embarrassed about the appearance of their ulcers or the need to use assistive devices, such as crutches or walkers, which can make them self-conscious in public settings. This leads to social isolation, as patients may withdraw from activities they once enjoyed, including family gatherings, social events, or even casual outings with friends.

Furthermore, the condition can strain relationships, especially when a patient requires help with daily activities like wound care or mobility assistance. Caregivers, often spouses or family members, can feel the burden of this responsibility, which may create tension or feelings of helplessness within families.

Despite the daunting challenges of living with a chronic diabetic foot ulcer, there is hope through advanced wound care technologies and treatments. Specialized wound care clinics offer comprehensive, multidisciplinary approaches to treating chronic DFUs, using therapies such as skin substitutes, negative pressure wound therapy (NPWT), hyperbaric oxygen therapy (HBOT), and advanced dressings to promote faster healing and reduce the risk of amputation.

Moreover, early detection and proactive management of diabetes can prevent the development of foot ulcers altogether. By regularly checking feet, managing blood sugar levels, and using appropriate footwear, patients can significantly reduce the likelihood of experiencing a DFU.

Chronic diabetic foot ulcers not only threaten a patient’s health but also impede their ability to lead a full, fulfilling life. The physical limitations, emotional distress, and financial burdens associated with these ulcers create a complex challenge for both patients and healthcare providers. However, with advanced wound care treatments and proactive diabetes management, there is hope for healing and a return to a better quality of life.

By raising awareness of the challenges posed by DFUs and advocating for timely, specialized care, we can help individuals living with diabetes avoid the devastating consequences of chronic wounds and lead more active, independent lives.

Sources:

American Diabetes Association. (n.d.). Statistics About Diabetes. Link

Diabetic Medicine. (2013). Psychological Impact of Diabetic Foot Ulcers. Link

Diabetes Care. (2020). Economic Costs of Diabetes in the U.S. Link

Nature's Healers: Orangutans and FloraSeptic Wound Gel

We are thrilled to share a fascinating discovery that connects the healing wisdom of nature with modern medical advancements. A recent study(1) highlighted by BBC reveals that an orangutan in Borneo used a specific medicinal plant to treat a facial wound. This remarkable behavior showcases the incredible intelligence of these creatures and underscores the efficacy of natural remedies.

According to the study(2), orangutans have been observed using leaves from the Akar Kuning plant, which possess powerful healing properties. This plant contains Fibraurea tinctoria, a bioactive compound with anti-inflammatory and anti-microbial properties, aiding the orangutan to treat his wound effectively.

What makes this discovery even more exciting is the fact that berberine, the active ingredient found in Akar Kuning, is a key component in FloraSeptic Wound Gel(3). At FloraSeptic, we have long understood the synergy of nature and science, and this revelation from the wild only strengthens our commitment to using the highest quality botanical derivatives in all our products.

This alignment with nature enhances the efficacy of FloraSeptic but also emphasizes our dedication to sustainability and respect for the environment. As we continue to innovate and develop new products, we remain inspired by the wisdom found in nature. The orangutans' use of Akar Kuning is a testament to the incredible potential of FloraSeptic in wound healing.

Stay connected with us for more updates on how we integrate nature’s best into our products to bring you safe, effective, and environmentally friendly solutions.

References:

• Wounded orangutan seen using plant as medicine – BBC Science reporter, Georgina Rannard, May 2, 2024

• Active self-treatment of a facial wound with a biologically active plant by a male Sumatran orangutan - https://doi.org/10.1038/s41598-024-58988-7

• FloraSeptic Wound Gel – www.FloraSeptic.com

Dr. Martin Johnson joins WoundCentrics San Antonio Wound Clinic

Martin Johnson, M.D., a Plastic Surgeon and Wound Specialist, has joined WoundCentrics as a wound care provider at the CHRISTUS Santa Rosa Wound Care and Hyperbaric Center at the Medical Center.  He has moved his long time Plastic and Reconstructive Surgery practice from the Phoenix Arizona market to San Antonio.   

An Arizona native that attended Arizona State University, Dr. Johnson received his Medical Degree from Baylor College of Medicine in Houston, Texas.  He completed his Internship, Residency and General Surgery, and a Residency in Plastics Surgery at the Medical College of Virginia, Richmond, Virgina. 

Dr. Johnson is Board Certified by the American Board of Plastic Surgery and is a certified Wound Care Specialist. He recently completed educational credits at Wound Care University in New Braunfels, Texas. 

“We are pleased that Dr. Johnson is bringing his clinical, research and leadership experience to WoundCentrics at the CHRISTUS Santa Rosa Wound Care and Hyperbaric Program in the Medical Center at San Antonio, Texas,” stated Dr. Marcus Gitterle, Chief Medical Officer for WoundCentrics.

Dr. Johnson will focus on treating patients with chronic, non-healing wounds, including diabetic foot ulcers, arterial and venous ulcers, pressure wounds and bone infections.  Dr. Johnson will oversee the Hyperbaric Oxygen Therapy Treatments in the clinic too.  Dr. Johnson will be accepting new patients at the Christus Santa Rosa Medical Center outpatient Wound & Hyperbaric Clinic located at 2833 Babcock Road, Suite 105, Tower II, San Antonio, Tx 78229.   

For more information visit the website at woundcentrics.com

Vitamin K: A Breakthrough Treatment for Calciphylaxis

Calciphylaxis, a severe condition characterized by calcification of small to medium-sized blood vessels leading to skin necrosis and potential organ failure, and an incredibly high one year mortality rate of uo to 70%, has posed significant management challenges. Recent advances, however, have illuminated a promising treatment modality: vitamin K. Specifically, studies indicate that vitamin K's role in activating the matrix Gla protein (MGP) - an inhibitor of vascular calcification - addresses the core pathophysiology of calciphylaxis.

Traditionally, sodium thiosulphate (STS) has dominated as the primary treatment option, lauded for its calcium-chelating and antioxidant properties. However, its effects on patient survival remain questionable, with many studies showing no marked reduction in mortality. Additionally, adverse side effects like nausea, hypotension, and potential exacerbation of hypercalcemia further limit its applicability.

This brings us to the groundbreaking findings of a recent study. In the words of Dr. Sagar U. Nigwekar and colleagues:

"In a 12-week phase 2 study that enrolled 26 patients with calciphylaxis, Sagar U. Nigwekar, MD, MMSc, of Massachusetts General Hospital in Boston, and colleagues found that patients treated with oral phytonadione, a form of vitamin K, was associated with a significantly lower mortality rate compared with placebo at 12 weeks (0% vs 31%). In addition, phytonadione-treated patients experienced significant decreases in the size of a patient’s largest skin lesion, the combined size of all lesions, and pain intensity compared with placebo.” (1).

The implications of this study are profound. Not only does vitamin K supplementation show promise in reducing lesion size and pain intensity, but its potential to slash mortality rates to zero sets it apart from other treatment modalities like STS.

As the Chief Medical Officer of a Wound Care specialty group involved in treating Calciphylaxis in more than 100 facilities in the US, I am frequently called upon to direct treatment of patients with this condition. Since 2019, our group, based on evidence from the Mass General clinical trial referenced in this article, has been using vitamin K as a principal treatment strategy, with excellent results regarding wound healing and mortality risk. There have been no significant adverse events to date. What is discouraging is the fact that since 2019, our team has yet to encounter a clinician who is familiar with this treatment strategy.

We feel that vitamin K will supplant other treatment methods for Calciphylaxis for several reasons.

1. Targeted Action: Unlike STS, which offers a broader approach to symptom management, vitamin K directly rectifies the vitamin K deficiency that inactivates MGP, a crucial player in the pathophysiology of calciphylaxis.

2. Safety Profile: With an appropriately monitored regimen, vitamin K supplementation exhibits a favorable safety profile, overshadowing the numerous side effects associated with STS.

3. Mortality Reduction: The potential of vitamin K to drastically reduce mortality rates in calciphylaxis patients, as demonstrated in Dr. Nigwekar's study, is a breakthrough in itself.

What is also relevant is that vitamin K is found in two major forms: vitamin K1, or Phylloquinone, found mainly in green, leafy vegetables, and K2, or Menaquinone, found mainly in fermented foods that are uncommon in the US, such as Natto.

Importantly, vitamin K1 is mainly active in the liver, producing blood-clotting proteins. In contrast, vitamin K2 is primarily active outside the liver, which is responsible for activating Matrix GLA protein.

Vitamin K2 is 10 times as potent as vitamin K1 as an activator of Matrix GLA protein while being 1/10 as active in the liver in the synthesis of clotting factors, making it the better choice for the treatment of calciphylaxis because it activates that desired protein, while being less likely to foster a hyper-coagulable state.

In Dr. Nigwekar’s Mass General clinical trial, vitamin K1 was utilized (10mg PO, three times per week). Since most hospital formularies do not contain K2, we typically have utilized the vitamin K1 regimen for inpatients. Upon discharge, I believe it is preferable to transition the patient to vitamin K2, 1mg daily. There are a number of OTC vitamin K2 products, which contain from 90mcg to 1mg of K2.

We recommend choosing a preparation containing at least 600mcg of K2, which can be dosed as two capsules, PO daily. By transitioning to K2, therapy can become more specific in activating the desired Matrix GLA protein and limiting the risk of thrombotic complications. Studies such as Schurgers et al., 2007, have found no association between vitamin K2 intake and increased thrombosis risk (2).

While sodium thiosulphate served its purpose when options were limited, the dawn of a more effective treatment strategy is upon us. Vitamin K, by addressing the root cause of calciphylaxis, promises symptom relief and a profound reduction in mortality risk. It is incumbent on those involved in treating this disease to become familiar with vitamin K treatment for Calciphylaxis to reduce the morbidity and mortality risk of this condition.

1. Nigwekar SU, Krinsky S, Thadani RI, et al. Phase 2 trial of phytonadione in calciphylaxis. Presented at the American Society of Nephrology’s Kidney Week 2019 meeting held Nov. 5 to 10 in Washington, DC. Poster TH-PO1188.

2. Schurgers, L. J., & Vermeer, C. (2007). Determination of phylloquinone and menaquinones in food. Effect of food matrix on circulating vitamin K concentrations. Haemostasis, 30(6), 298-307

The Difference WoundCentrics Makes in Specialized Wound Care

In healthcare, wound care often gets less attention than acute and chronic diseases, yet it plays a critical role in improving patients' quality of life. Non-healing wounds, pressure ulcers, and diabetic foot ulcers can lead to severe complications if not effectively managed. That is where WoundCentrics steps in, making a significant difference in caring for patients with complex wounds. Through its specialized providers, trained extensively by Wound Care University, WoundCentrics is redefining what quality wound care looks like. 

At the heart of WoundCentrics' approach is its commitment to excellence in training. WoundCentrics invests heavily in the education of its healthcare providers, offering training programs through Wound Care University. This university is designed to deliver in-depth knowledge and skills specifically for wound care management. Through its specialized curriculum, Wound Care University covers everything from the basic principles of wound healing to the latest advancements in wound treatment modalities. 

The result? Every provider within the WoundCentrics network is well-versed in standard wound care protocols and equipped to handle complex, difficult-to-treat wounds that require a high level of expertise. This ensures patients receive care from professionals specialized in wound management rather than general practitioners with limited wound care training. 

One of WoundCentrics' key differentiators is its dedication to evidence-based care. The knowledge imparted by Wound Care University is rooted in the latest research and medical advancements in wound care. Providers learn about innovative treatments such as bioengineered skin substitutes, negative pressure wound therapy, and advanced wound dressings that can accelerate healing and reduce complications. 

By applying these cutting-edge techniques, WoundCentrics specialists can often achieve better outcomes in less time, reducing the risk of infection and the need for more invasive interventions like amputations. For patients suffering from chronic wounds, this can be life-changing. 

WoundCentrics emphasizes the importance of collaboration in wound care. Providers trained by Wound Care University are taught to work closely with other healthcare professionals, including primary care physicians, vascular specialists, podiatrists, and physical therapists. This team-based approach ensures that the wound care process considers every aspect of the patient's health. 

For example, a non-healing leg ulcer patient may benefit from advanced wound care and a consultation with a vascular surgeon to assess circulation issues. By coordinating care across disciplines, WoundCentrics ensures patients receive the comprehensive treatment they need to heal. 

WoundCentrics sets the standard for wound care by focusing on specialized education, evidence-based treatments, and holistic patient care. Through its Wound Care University, it ensures that every provider is highly trained in the most advanced wound care techniques and equipped to deliver superior outcomes. For patients dealing with the challenges of chronic or non-healing wounds, the difference that WoundCentrics makes is profound: faster healing, fewer complications, and a better quality of life. 

As the demand for specialized wound care continues to grow, WoundCentrics stands out as a leader in the field, delivering expert care that transforms patients' lives. 

Kent Imaging and WoundCentrics Propel Wound Care Forward With New Partnership

WoundCentrics includes SnapshotNIR as part of a system-based approach to patient-centered wound care.

CALGARY, ALBERTA, CANADA, April 2, 2024 /EINPresswire.com/ -- Kent Imaging is excited to be a part of the next steps WoundCentrics is taking to advance its patient care by incorporating SnapshotNIR as a point-of-care imaging tool. WoundCentrics’ system-based approach to each patient prioritizes the rapid acquisition of key data relevant to the patient’s assessment and treatment.

Vascular evaluation is integral to optimal decision-making in wound care. By enabling better vascular assessment at the point-of-care by including SnapshotNIR on initial and follow-up visits, the WoundCentrics team is better able to create optimal patient-centric care plans and achieve better outcomes.

“Our clinicians are trained in the multifaceted nature of wound care decision-making,” states Dr. Marcus Gitterle, MD, Chief Medical Officer of WoundCentrics. He adds, “We envision SnapshotNIR as a key component of risk reduction by having documentation and data from the device to better enable our teams’ clinical decisions.”

Not only does this partnering between Kent Imaging and WoundCentrics benefit patients, but physicians will be able to expand their research capabilities. With Kent’s eye for innovation and WoundCentrics’ mission to continue to contribute high quality research to move the industry forward, this is an exciting opportunity to elevate the standard of wound care.

WoundCentrics is a multi-state wound care provider, servicing patients through multidisciplinary teams with exceptional wound care expertise across all patient care domains including inpatient STACH, LTACH, IRF, SNF, LTC, and the home setting. Their system-based approach includes head-to-toe assessments and re-evaluations of patients through daily care from inpatient wound care providers to weekly outpatient visits in the clinic setting.

“Regardless of the patient care domain, we expect SnapshotNIR to become a key tool in our system-based patient management protocols, providing rapid, actionable, objective data to confirm the clinician’s observation and current diagnostics,” states Dr. Gitterle, he continued, “Faster delivery of this data means more efficient and effective patient care, ultimately giving time back to the patient in circumstances where time can mean saving a limb or making a decision regarding invasive surgical interventions.”

SnapshotNIR is an imaging device that uses reflectance-based technology to measure the hemoglobin and oxygen saturation of tissues 2-3 mm below the skin. Tissue oxygen saturation (StO2) is essential to wound healing and understanding a patient’s health status. Snapshot is a non-invasive, portable device that clinicians can use during bedside assessments, providing instantaneous data to support treatment planning, validate efficacy, and facilitate patient adherence to treatments like hyperbaric oxygen therapy (HBOT), a service WoundCentrics provides.

“We believe in the difference that SnapshotNIR can make in a patient’s healing progression,” says Kent’s Chief Executive Officer, Pierre Lemire, “With Snapshot in the skilled hands of WoundCentrics’ providers, we’re moving in the right direction keeping patients at the center of our cause, improving outcomes in as many patients and places as possible.”

Imaging procedures with SnapshotNIR have applicable CPT codes for reimbursement. To find out more, visit our dedicated reimbursement page online.

About Kent Imaging
Kent Imaging, located in Calgary, Alberta, Canada, is a leading innovator in near-infrared tissue oxygenation imaging, which develops, manufactures, and markets medical technology that supports real-time decision-making in wound care, vascular and surgical subspecialties. Kent holds multiple patents in oxygen imaging technology and continues to provide innovative and advanced diagnostic imaging solutions to aid healthcare systems nationally and internationally. SnapshotNIR is supported by clinical evidence demonstrating its ability to help improve clinical decision-making in wound care and reduce healing time. Since receiving FDA and Health Canada clearance in 2017, the technology has been featured in several published articles and peer-reviewed posters. Applying the knowledge gained from clinical trials to patient care promotes consistency of treatment and optimal outcomes.

About WoundCentrics
WoundCentrics is based in New Braunfels, Texas, USA, and operates fourteen wound centers and provides advanced wound care services in more than one hundred inpatient facilities across twelve states with a goal of providing advanced wound care, amputation prevention and vascular services to these communities.

Leah Pavlick
Kent Imaging Inc.

NEWS PROVIDED BY

Kent Imaging Inc.

April 02, 2024, 13:00 GMT

Platelet Rich Plasma: Expanding Options for Non-Healing, Chronic Wounds

A substantial percentage of non-healing, chronic wounds fail to heal, even under expert care by wound specialist providers, necessitating the application of special care, involving “Advanced Modalities,” such as Hyperbaric Oxygen Therapy, and Engineered Dermal Substitutes, sometimes referred to as “synthetic skin.” While such “Advanced Modalities” can provide significant benefits to patients, they are expensive, not universally available, and reimbursement for their use is quite restrictive.

At present, third-party payers restrict reimbursement for engineered grafts to specific wound types and locations; namely Diabetic Foot Ulcers, and Venous Leg Ulcers, and restrict Hyperbaric Oxygen Therapy, as a chronic wound treatment modality to Diabetic Foot Ulcers, and chronic, radiation-related wounds.

Those site and etiology-based restrictions leave many patients with diabetes who also have non-healing ulcers of sites other than the foot, bereft of options. Fortunately, an exciting new option is available for diabetic patients with non-healing ulcers at any site, as long as non-healing is related to underlying complications of diabetes, such as microvascular disease, white blood cell, or fibroblast dysfunction.

The technology we are referring to is Platelet Rich Plasma or PRP, which is not a “new technology,” per se. In fact, PRP has a proven track record in regenerative medicine, and particularly within orthopedic medicine, where it has been used for more than a decade to improve outcomes in patients with complex tendon, muscle, bone and joint problems. In fact, the very basis for the successful application of PRP to orthopedic problems underlies its benefits as an Advanced Modality in wound care.

From a technical standpoint, PRP is a biologically derived product — a type of Autograft —  sourced from the patient's own blood. Using a simple process that can be quickly performed in the wound clinic, the patient’s blood is utilized to create a jelly-like graft material that is enriched with growth factors, activated platelets, fibrin, and other bioactive elements essential for tissue repair and regeneration.

Not only does PRP provide a potential solution for diabetic patients without other reimbursable treatment options, it provides a unique combination of benefits that are not seen with existing solutions, such as amniotic grafts. These benefits include:

1. Tissue Regeneration: PRP accelerates the body's natural healing processes via endogenous, patient-derived cytokines, promoting the regeneration of damaged tissue by enhancing synthesis of new blood vessels, and collagen synthesis, both of which are necessary prerequisites for wound healing.

2. Infection Control: PRP exhibits inherent antimicrobial properties, which contribute to infection control within the wound environment, creating a conducive setting for healing, and offsetting some of the detriments to wound healing posed by biofilms — bacterial structures that are found in most, chronic wounds that strongly inhibit healing.

3. Inflammation Modulation: PRP also plays a role in modulating the inflammatory response, a pivotal factor in the pathophysiology of chronic wounds, thus facilitating the healing process.

4. Scar Reduction: Notably, PRP therapy has demonstrated the potential to minimize scarring and improve cosmetic outcomes, a welcome benefit for patients concerned about aesthetic consequences.

The PRP Treatment Protocol is straightforward, and easily repeatable by wound clinic personnel after brief training, and consists of the following, simple steps:

1. Blood Collection: A modest volume of the patient's blood is drawn, mirroring the process employed for standard blood test specimen collection.

2. Centrifugation: The blood sample undergoes centrifugation to isolate PRP from other blood constituents.

3. Application: The concentrated PRP is applied directly to the wound site, and can also be applied via targeted injection, depending on wound characteristics and anatomical considerations. The jelly-like consistency of PRP lends itself to application to complex wound shapes, and sinus tract wounds that would be difficult to cover with planar or sheet materials.

4. Dressing and Monitoring: Following PRP application, an appropriate wound dressing is applied, and close monitoring is conducted to assess the progress of wound healing.

Conclusion

In Platelet Rich Plasma (PRP) therapy, we have a noteworthy addition to our arsenal of wound care strategies. It offers a hope for a wider range of individuals grappling with non-healing, chronic wounds. By harnessing the body's inherent regenerative capabilities, PRP promises expedited wound closure, a reduction in complications, and an improvement in overall quality of life. As we navigate this therapeutic landscape, we stand at the precipice of innovation, holding the potential to significantly enhance patient outcomes and usher in a new era in the domain of wound management. Embracing this emerging approach represents an opportunity for substantive improvements in the treatment of chronic wounds and a reconfiguration of established paradigms in the field.


Marcus Gitterle, MD, FACCWS, ABWM
Chief Medical Officer
WoundCentrics, LLC

Diabetic Foot Care for Patients

If you have diabetes, here’s a way to keep standing on your own two feet: check them every day—even if they feel fine—and see your doctor if you have a cut or blister that won’t heal.  

There’s a lot to manage if you have diabetes: checking your blood glucose, making healthy food, finding time to be active, taking medicines, and going to doctor’s appointments. With all that, your feet might be the last thing on your mind. But daily care is one of the best ways to prevent foot complications.  

There’s a lot to manage if you have diabetes!  

Some people with nerve damage have numbness, tingling, or pain, but others have no symptoms. Nerve damage can also lower your ability to feel pain, heat, or cold. 

What’s the most important thing you can do to prevent nerve damage or stop it from getting worse? Keep your blood sugar in your target range as much as possible. Other good diabetes management habits can help, too: Stop smoking! Smoking reduces blood flow to the feet.  

Follow a nutrition plan, including eating more low-glycemic fruits, such as berries and vegetables, and avoid anything with sugar in it, including fruit juices, sodas, pastries, and candies. Physical activity—10 to 20 minutes a day is better than an hour once a week.  

Take medicine as prescribed by your doctor. Anyone with diabetes can develop nerve damage, but these factors increase your risk:  Blood sugar levels that are hard to manage, having diabetes for a long time, especially if your blood sugar is often higher than your target levels, being overweight, being older than 40 years, having high blood pressure and having high cholesterol.  

Nerve damage, along with poor blood flow—another diabetes complication—puts you at risk for developing a foot ulcer (a sore or wound) that could get infected and not heal well. If an infection doesn’t get better with treatment, your toe, foot, or part of your leg may need to be amputated (removed by surgery) to prevent the infection from spreading and to save your life. When you check your feet daily, you can catch problems early and treat them immediately. Early treatment greatly reduces your risk of amputation.  

One of the best ways to prevent foot infections and amputations is to Inspect your feet daily!  

Get to the bottom of any foot problems by using a mirror or asking for help. Check your feet daily if you have lessened sensation.  

Career Growth & Advancement are A Reality at WoundCentrics

Shellie Torres, Director of Human Resources 

Shellie Torres is the Director of Human Resources for WoundCentrics, a Texas-based Wound Care company. WoundCentrics is a growing healthcare company that is hiring new team members. The current team is creating new opportunities through client growth, which also creates career growth opportunities for existing and new team members. Shellie's team is responsible for the hiring process at WoundCentrics, and she is an example of what career growth can look like in the company.  

Shellie began her career with WoundCentrics in February 2016 as a recruiter. After several job advancements where she took on progressive responsibility, she was ultimately promoted to Director of Human Resources in January 2022.   

In 2017, Shellie decided to grow her career by furthering her education and taking advantage of company benefits to support her career growth. Shellie outlined a plan with her managers at WoundCentrics to achieve the education and career development she received from her involvement in the Lubbock chapter of the Society for Human Resource Management (SHRM) where she eventually became chapter President.  

SHRM is a professional human resources membership association that provides education, certification, and networking to its members, while advocating on issues pertinent to labor management. 

"I was ready for another stage in my career in 2017," stated Torres. "I wanted a new challenge, I wanted to make a difference for our associates, and I knew I needed more education to get there.”  

"I decided to grow within the company, which meant focusing on my education. I completed my bachelor's degree in 2020 and my master's degrees in 2022 which resulted in advancing to a new role and taking on more responsibility,” continued Torres. "I also gained new skills, met new people, and gained a new perspective on my role in the company as the Director of HR. Professional growth and advancement can make you feel more satisfied with your position and more confident in your job-related skills," stressed Torres.  

In today's healthcare market — the more skilled and educated employees are, the better a business performs in operations, outcomes, and profitability. As Shellie's experience shows, employee education and job skills open doors. WoundCentrics is an advocate for and supportive of motivated employees' goals and plans for career growth.  

“I was fortunate to have employers throughout my career that supported career growth through education and professional development, whether that be financially or through time to serve on committees and boards that broadened my knowledge and understanding of my profession and those I worked with. It is an honor and a pleasure to extend that opportunity those who work for WoundCentrics and our family of companies so that they can hopefully have a similar experience,” share Stuart Oertli, WoundCentrics’ Chief Operating Officer.  

A recent Indeed article pointed out that companies benefit from employees who seek out opportunity for career growth. The report said that aside from company perks and monetary compensation, today's top talent looks for employers that enable them to learn and grow professionally.   

As WoundCentrics seeks highly qualified talent in today's healthcare market and as competition for employees continues to increase, the opportunity for career growth is one of the most critical concerns to the modern job seeker when evaluating a prospective employer – and this is also true for existing employees.  WoundCentrics has taken steps to develop in house continuing education, has monthly provider education meetings for it’s direct care providers, has developed provider onboarding for new wound care practitioners and actively encourages associates to attend and present at professional conferences. 

Shellie Torres has talked and walked the talk and is an example of what hard work, commitment, education, and a career plan can yield at WoundCentrics.  

For more about careers at WoundCentrics, visit our careers page.

Debridement: How can we help a wound heal by making it larger?

It is often a point of confusion for patients, family members, and even clinical professionals, when debridement is recommended for the treatment of an acute, or chronic wound. “Why would making a wound larger be helpful, when our goal is to make it heal?"

Debridement is the removal of dead, damaged, or infected tissue from a wound, and it is a standard part of wound care for many types of wounds. The benefits of debridement are well-established and supported by a large body of clinical evidence.

Debridement helps to promote wound healing by removing debris, bacteria, and other harmful substances from the wound bed, which can impede the healing process. It also helps to stimulate the growth of healthy new tissue, which can speed up the healing process.

Several studies have demonstrated the benefits of debridement for wound healing. For example:

1. A systematic review and meta-analysis published in the Journal of Wound Care in 2019 found that debridement was associated with a significant reduction in wound healing time and a higher rate of complete wound healing compared to non-debridement treatments.

2. A randomized controlled trial published in the Annals of Emergency Medicine in 2015 found that debridement of traumatic wounds reduced the risk of infection and improved wound healing outcomes compared to non-debridement treatment.

3. A systematic review and meta-analysis published in the Cochrane Database of Systematic Reviews in 2016 found that debridement was associated with a faster rate of healing and a reduced risk of infection in diabetic foot ulcers.

Overall, the clinical evidence strongly supports the use of debridement as a standard part of wound care for many types of wounds. It's important to consult with a healthcare provider to determine the most appropriate debridement technique for a specific wound, as there are different types of debridement, including surgical, mechanical, enzymatic, and autolytic debridement, and the most appropriate technique may depend on the type and severity of the wound.

WoundCentrics providers receive extensive training in the theory and techniques of debridement, making them uniquely capable of delivering high-quality wound care, tailored to the Whole Patient, not just the hole in the patient.

Omega 3 Fats are Finding a New Role in Wound Therapeutics

Omega 3 Fatty acids are well known to most people these days as an important component of a healthy diet. They are known to impact heart health, and reduce inflammation, but, could they be useful in wound healing?

Yes, there is research supporting the use of topical omega-3 fatty acids to treat wounds. Omega-3 fatty acids have been shown to have anti-inflammatory and wound healing properties, making them potentially useful in the treatment of various types of wounds.

A study published in the Journal of Investigative Dermatology in 2013 found that topical application of an omega-3 emulsion helped to accelerate wound healing in mice. The study found that the omega-3 emulsion reduced inflammation and increased collagen synthesis, which are important factors in the wound healing process.

Another study published in the Journal of Wound Care in 2018 looked at the effects of a topical omega-3 dressing on the healing of diabetic foot ulcers. The study found that the omega-3 dressing was associated with faster wound healing and a reduced risk of infection compared to a standard dressing.

Overall, while more research is needed to fully understand the potential benefits of topical omega-3 fatty acids in wound healing, there is evidence to suggest that they may be a useful addition to standard wound care treatments. It's important to consult with a healthcare provider before using any new treatments for wounds or other medical conditions.

At WoundCentrics, we will be following Omega 3-based topical therapies, as well as scanning the horizon for breakthroughs that can help our provider team heal our patients as fast as possible. Staying abreast of the latest developments in the science of wound healing is part of our mission.

Engineered Dermal Substitute

Chronic wounds are a growing challenge for medical professionals, and systems. While there are fundamental interventions that are applicable to most or all problem, or chronic wounds, such as wound bed preparation, supplemental nutrition, optimization of co-morbid conditions such as diabetes, and assessment and correction of vascular deficits, if present, no all wounds heal, even when best-practices are followed, and these areas addressed.

In the effort to facilitate healing in patients who fail to respond to full-spectrum standard wound care, advanced modalities are an increasingly important option. One type of Advanced Modality is called an Engineered Dermal Substitute. There are now more than 700 FDA approved dermal substitute products, and several distinct sub-categories within this larger grouping.

An engineered dermal substitute (EDS) is a type of skin substitute that is used to treat wounds or defects in the skin. It is made of biocompatible materials that mimic the structure and function of human skin, and is designed to promote the growth of new tissue.

EDS typically consists of a three-dimensional scaffold made of biocompatible materials such as collagen, hyaluronic acid, or synthetic polymers. This scaffold is seeded with cells such as fibroblasts or keratinocytes, which are key cells involved in the healing process. The cells grow and organize within the scaffold, creating a new layer of tissue that can integrate with the surrounding skin.

EDS can be used to treat a variety of skin injuries, such as burns, chronic wounds, and ulcers. It can also be used for reconstructive surgery to replace lost or damaged skin. EDS has several advantages over traditional skin grafts, including a reduced risk of infection, less scarring, and the ability to customize the scaffold to fit the specific needs of the patient.

While EDSs have shown promise in clinical trials, they are still a relatively new technology and further research is needed to determine their long-term safety and effectiveness. However, they have the potential to be an important tool in the treatment of chronic wounds, and could help improve the quality of life for patients with these conditions.

The Effects of Smoking on Wound Healing

A chronic wound is not an isolated problem, but is often a symptom of chronic diseases that occur due to genetics and lifestyle choices. Although genetic makeup is not a modifiable factor, lifestyle choices are. Specifically, tobacco use is a choice that can significantly impair wound healing. However, there is good news for those patients who use tobacco products and suffer from chronic wounds. By giving up tobacco use, one can significantly improve wound healing and reduce overall wound care expenses.  

American culture tends to emphasize smoking cessation and the dangers of tobacco use in public school education and medical practices, yet according to the CDC (2022) about 30.8 million American adults still pursue habitual tobacco use. Furthermore, smoke exposure through second-hand smoke reaches a broader range of Americans with 41,000 deaths annually among non-smoking adults (CDC, 2022).  

Smoking increases overall mortality risk and negative health outcomes. Specifically, with wound care, the effects can be detrimental to wound healing. Smoking negatively impacts wound healing by impairing the immune system and reducing blood flow in the skin required for healing. Blood circulation delivers oxygen and nutrients to the cells, promoting the closure of wounds. Nicotine causes vasoconstriction which is the narrowing of blood vessels. Vasoconstriction reduces the perfusion of the wound bed and can delay tissue growth, thus delaying healing.  

The immune system is also impaired with nicotine use because white blood cells depend on normal oxygen levels in order to kill bacteria. By lowering tissue oxygen levels increasing risk of infection, which can lead to abscess formation, wound treatment failure, limb amputation, and even premature mortality. Delivery of nutrients to the wound bed is also decreased with tobacco. Nutrients like Vitamin C are a vital component needed in wound healing along with Vitamins A, D, and zinc.  

Through nicotine exposure, whether from cigarette smoking, vaping, smokeless tobacco, or even nicotine gum, the overall process of wound healing is hindered, thus increasing the physical and financial demands on the patient. Delayed wound healing can increase doctor visit frequency, loss of wages, use of wound care products, prescriptions, and financial burden needed to address the open wound. The risk of continuing tobacco use can be detrimental to overall health.  

The great news is that a 2016 study showed patients who stopped smoking for eight hours had oxygen levels normalize in the bloodstream. The same study showed that after 24 hours of smoking cessation, nerve endings started to recover. After two weeks, blood flow improved and helped increase mobility. The dangers of smoking to wound healing and overall health far outweigh the challenges of smoking cessation. Resources are available to assist with smoking cessation. Chronic wounds are challenging to heal, but smoking cessation can expedite the healing process. 

Proper Nutrition Enhances Proper Wound Healing

A significant number of people who have acute, slow healing, or chronic wounds are nutritionally impaired.  Proper wound healing is enhanced by taking in adequate amounts of dietary protein, Vitamin A, Vitamin C, Vitamin D, and Zinc, as well as hydration.  Many people who have wounds eat a diet that consists of heavy amounts of carbohydrates and fats and not enough proteins, fruits, and fresh vegetables.   

Wound healing occurs in 4 distinct phases.   

•  Hemostasis- This phase occurs immediately after the wound is created and refers to a series of biologic processes which result in decreased bleeding.  

•  Inflammatory Phase- This phase starts as bleeding is being controlled. During this phase a variety of specialized white blood cells and other immune system mediators are transported to the site of injury. This phase usually lasts for 2 weeks and causes localized swelling, pain, tenderness, and redness.  

•  Proliferative phase- This phase usually lasts for 3 to 4 weeks. In this phase large numbers of special cells called fibroblasts produce collagen. Collagen is a protein which is the primary “building block” of the structure of all live animals. Without collagen there would be no bones, muscle, skin or wound healing. This is the phase in which the wound becomes smaller by contraction and is covered with new skin. This is also the most common phase in which wounds “get stuck” and stop healing.  

•  Remodeling- This is the final stage of wound healing and lasts for up to 1 year after the wound was formed. During this time collagen fibers become linked together and increase the strength of the final scar. The scar continues to shrink and changes color from red to the normal skin color. 

Proper nutrition is necessary for the phases of wound healing to proceed normally. The single most important nutritional supplement needed is protein. Dietary protein is broken down into amino acids which are used by fibroblasts to synthesize the new structural proteins and are essential for wound healing and the repair of injured tissues.  If dietary intake of protein is inadequate, healthy protein from other body tissues will be broken down and used for wound healing. This is obviously counterproductive for the otherwise healthy tissues such as muscle and bone. It is recommended to take protein supplements in addition to animal protein eaten daily with meals. There are numerous products available at most grocery stores and pharmacies. The recommended dose is 2 servings per day of a 30gm protein supplement. Patients with diabetes need a supplement that has reduced sugars, and patients with renal failure or liver problems may also require a specialized protein supplement to avoid metabolic complications.  Please consult with your physician if you have renal failure or liver problems prior to purchasing an over the counter supplement. 

Several specific vitamins and minerals are also crucial for the phases of wound healing to proceed normally. 

Vitamins A, C, D, and Zinc are required in various stages of the wound healing process and in the regulation of a healthy immune system as well. Normal daily multivitamins do not contain adequate amounts of these to enhance wound healing. In addition to a daily over-the-counter vitamin the recommended doses of these are as follows:  

• Vitamin A- 5000 units per day 

• Vitamin C- 2000mg per day 

• Vitamin D3- 5000 units per day 

• Zinc- 50mg per day 

In summary, proper nutrition is one of key factors in proper wound healing. The best results in successful healing of difficult wounds are seen in a qualified Wound Care Center where the providers are trained in taking care of the whole patient to ensure wound healing.  They review important factors involved in wound healing and monitor each patient closely until a successful outcome is achieved. 

Wound Care University to train all WoundCentrics Physicians, Advanced Practice Providers and Allied Health Professionals on Hyperbaric Medicine and Advanced Wound Care

WoundCentrics, a full-service wound care management company, uses Wound Care University in New Braunfels, Texas exclusively to train its employed and contracted physicians, advanced practice providers and allied health professionals for hyperbaric medicine training. The Wound Care University 40-hour Introduction to Hyperbaric Medicine course is an Undersea Hyperbaric Medicine Society approved course and offers CME to the physicians that complete the course and pass the exam.

“Our company offers all our providers the clinical training needed to achieve their advanced wound care and hyperbaric medicine certifications. Wound Care University provides the quality education and professional advancement that our company is seeking to offer our clinicians,” stated Stuart Oertli, Chief Operating Officer of Wound Centrics.

“The basic and advanced wound care training provided by Wound Care University builds the foundation needed for the WoundCentrics clinical providers to become proficient at the various therapies, modalities and treatments required to be an advanced wound care professional in our industry,” according to Marcus Gitterle M.D, Chief Medical Officer of WoundCentrics.

“We train our providers in advanced wound care to be able to work in the acute hospital inpatient setting, and in the post-acute setting, including the rehabilitation hospitals, long term acute care hospitals, skilled nursing home facilities, and long-term care,” Oertli explained. “The expanding sub-specialty of wound care is evolving rapidly, and our providers are trained to be up to date and proficient on the latest evidenced-based treatments of wound healing,” explained Dr. Gitterle.

WoundCentrics was founded 12 years ago in San Antonio, Texas. The company has grown to have a large national footprint, operating in ten states and in more than ninety-two facilities. Through its physician employment group, Physician’s Unity, it employs sixty-four providers and more than seventy-five other clinical, administrative, and support staff.

In 2019, Wound Care University was founded to provide state-of-the-art wound care training and development for wound care clinicians, including an Undersea and Hyperbaric Medical Society (UHMS) approved course for new hyperbaric clinicians (www.woundcareuniversity.com). To learn more about WoundCentrics visit the website at www.woundcentrics.com.

WoundCentrics turns to inSight's wound measurement platform for scalability, quality data, and ease of use.

WoundCentrics Supports Focus on Diabetes Awareness and Education

November is American Diabetes Month

WoundCentrics is honoring Diabetes Month by joining the awareness and education campaign in the communities where we provide specialized wound care services. Currently, 34.2 million Americans have diabetes and 2 million are struggling to heal a diabetic foot ulcer. America’s diabetic population is expected to nearly double by 2030, it is important to know the risks associated with diabetic foot ulcers according to the American Diabetes Association:

• Up to 25% of people living with diabetes will experience a foot ulcer in their lifetime

• 14-24% of foot ulcers progress to amputation

• 85% of diabetes-related amputation were preceded by a foot ulcer

• 130,000 for a lower-extremity amputation (5.6 per 1,000 adults with diabetes)

• 50% of patients die within five years of amputation

WoundCentrics provides advanced wound care services that identify and specializes in treating wounds, including diabetic foot wounds.  WoundCentrics wound clinics coordinate wound care services with other healthcare services treating diabetic patients with other diabetic complications, manages and heals wounds, prevents amputations, and preserves the quality of life for diabetic patients.

WoundCentrics Wound and Hyperbaric Centers and the WoundCentrics Providers are specially trained in wound care and diabetic foot ulcer care, including hyperbaric oxygen therapy, a treatment for diabetic ulcer patients.

WoundCentrics’ mission is to support the National Diabetes Month to increase awareness of the risks, along with proper care for diabetic foot ulcers that can reduce diabetes-related amputations in the communities that they offer wound care services. For more information on WoundCentrics visit www.woundcentrics.com

Diabetes and the Complication of Diabetic Foot Wounds

According to the National Institute of Diabetes and Digestive and Kidney Disease (NIDDK), a division of the National Institute of Health (NIH),  National Diabetes Week brings awareness and focus to the major health issue of diabetes and the complications of diabetes like diabetic foot wounds and diabetic neuropathy.

Foot problems are common in people with diabetes. You might be afraid you’ll lose a toe, foot, or leg to diabetes, or know someone who has, but you can lower your chances of having diabetes-related foot problems by taking care of your feet every day. Managing your blood glucose levels, also called blood sugar, can also help keep your feet healthy.

WoundCentrics manages patients suffering from diabetes and foot complications and wounds every day.  If you have diabetes and a foot wound, WoundCentrics specialist and our wound and hyperbaric centers can help heal your wound and return patients to a better quality of life.

For more information on diabetes and foot care from the National Institute of Health visit https://www.nih.gov/

Diabetes Awareness Month

American Diabetes Awareness Month (or simply Diabetes Month) is an annual campaign throughout the month of November in the USA to bring awareness to the growing prevalence of diabetes, the health risks associated with it, raise funds for research into the condition, and support people living with it.

Diabetes is one of the fastest-growing, preventable medical conditions in the world.

Recent research by the Diabetes Research Institute published in 2020 also points to some alarming statistics. Among the US population overall the prevalence of diagnosed and undiagnosed people with the condition for 2018 were (crude estimates):

• 34.2 million people of all ages—or 10.5% of the US population—had diabetes

• 34.1 million adults aged 18 years or older—or 13.0% of all US adults—had diabetes

• 7.3 million adults aged 18 years or older who met laboratory criteria for diabetes were not aware of or did not report having diabetes (undiagnosed diabetes). This number represents 2.8% of all US adults and 21.4% of all US adults with diabetes

• The percentage of adults with diabetes increased with age, reaching 26.8% among those aged 65 years or older

Diabetes also affects different ethnic groups differently. The prevalence of diagnosed diabetes was highest among American Indians/Alaska Natives (14.7%), people of Hispanic origin (12.5%), and non-Hispanic blacks (11.7%), followed by non-Hispanic Asians (9.2%) and non-Hispanic whites (7.5%).

The condition also causes many deaths:

• In 2017, diabetes was the seventh leading cause of death in the United States. This finding is based on 83,564 death certificates in which diabetes was listed as the underlying cause of death (crude rate, 25.7 per 100,000 persons)

• In 2017, there were 270,702 death certificates with diabetes listed as the underlying or contributing cause of death (crude rate, 83.1 per 100,000 persons)

And the costs are astronomical!

• The total direct and indirect estimated costs of diagnosed diabetes in the United States in 2017 was $327 billion

• Total direct estimated costs of diagnosed diabetes increased from $188 billion in 2012 to $237 billion in 2017 (2017 dollars); total indirect costs increased from $73 billion to $90 billion in the same period (2017 dollars)

• Between 2012 and 2017, excess medical costs per person associated with diabetes increased from $8,417 to $9,601 (2017 dollars)

For the individual, the American Diabetes Association states that people with diagnosed diabetes incur average medical expenditures of $16,752 per year, of which about $9,601 is attributed to diabetes. On average, people with diagnosed diabetes have medical expenditures approximately 2.3 times higher than what expenditures would be in the absence of diabetes.

What is Diabetes?

Diabetes is a condition where the body is unable to naturally control the amount of glucose (sugar) in the blood. Blood sugar levels rise and in turn cause medical complications.

Glucose is the main source of energy we need to function (run, walk, and go about our daily lives). It is produced by the food we eat mostly through carbohydrates like bread, pasta, rice, potato, sweets, and chocolate.

However, to be used as energy glucose needs to pass through the digestive system and enter the body’s muscles and cells via the bloodstream. This transition of insulin from the blood to the cells is enabled by a hormone called insulin which is produced by the pancreas.

If the pancreas does not produce enough insulin or we become resistant to it, glucose will remain in the blood and cause blood sugar levels to rise.

The body’s inefficient use of insulin, a resistance to it, or when the pancreas has packed up altogether is the cause of diabetes and it can cause serious health problems as we discuss below.

Other Medical Problems

The number of deaths attributed to diabetes is staggering, but what are the medical conditions commonly associated with it? Diabetics are likely to be diagnosed with more medical problems than the average man or woman but many are preventable. These include stroke, heart disease, kidney disease, nerve damage, eye problems, dental disease, and foot problems.

In 2016, a total of 7.8 million hospital discharges were reported with diabetes as any listed diagnosis among US adults aged 18 years or older (339.0 per 1,000 adults with diabetes). These discharges included:

• 1.7 million for major cardiovascular diseases (75.3 per 1,000 adults with diabetes), including:

  • 438,000 for ischemic heart disease (18.9 per 1,000 adults with diabetes)

  • 313,000 for stroke (13.6 per 1,000 adults with diabetes)

  • 130,000 for a lower-extremity amputation (5.6 per 1,000 adults with diabetes)

  • 209,000 for hyperglycaemic crisis (9.1 per 1,000 adults with diabetes)

  • 57,000 for hypoglycemia (2.5 per 1,000 adults with diabetes)

Among US adults aged 18 years or older with diagnosed diabetes, crude estimates for 2013–2016 were:

• 37.0% had chronic kidney disease (stages 1–4), of which over half (52.5%) had moderate to severe chronic kidney disease (stage 3 or 4)

• 24.9% with moderate to severe chronic kidney disease (stage 3 or 4) were aware of their kidney disease

Clinical Benefits of Sharp Debridement

Wound debridement is considered by most wound experts to be a key aspect of wound management. Debridement facilitates several processes that are essential for wound healing, including the removal of dead and necrotic tissue. This “biological burden” is removed to control bacterial colonization, prevent wound infection and to allow the practitioner to properly visualize and assess the full extent of the wound and involved structures, so as to guide further treatment, optimize wound dressings and set the stage for more advanced treatments, such as engineered skin substitutes.

Sharp debridement not only promotes wound healing by removing impeding dead tissue and bacterial biofilm; it is also clear that debridement “resets” cellular signaling proteins to the acute phase of wound healing, allowing wound healing to proceed in a more optimal fashion. 

When debridement is performed on appropriate patients in a timely fashion, wound healing can proceed much more rapidly, leading to better outcomes, higher patient satisfaction, and lower overall wound care supply costs. When performed by appropriately trained providers, debridement can be effective and efficient, while imposing little overhead on facility operations, or additional burdens to caregivers. 

A very large retrospective analysis assessed wound outcomes in relation to frequency of wound debridement. This study, by Wilcox, Carter and Covington, looked at 154 644 patients with 312 744 wounds of all types over a 4 year period in 525 clinics, and demonstrated clear evidence of improvement in wound outcomes with increasing frequency of debridement (P > 0.001), and concluded “The more frequent the debridement, the better the healing outcome.” 

At WoundCentrics, we believe that appropriate debridement is merely one aspect of a comprehensive wound care program, but a very important one. Effective, timely debridement can mean the difference between excellent outcomes and high patient satisfaction, and merely average or even sub-optimal outcomes. That is why we train and certify our providers in this key aspect of wound care.

David Jones, FNP
Vice President of Clinical Services
WoundCentrics