Q. When do I know I need help with a wound that won’t heal?

A: Any wound that has not started to heal in 2 weeks or completely healed in 6 weeks may benefit from a specialized wound care center. Ask your regular physician if a referral to a center for wound care might be the right option for you. You can also come to a wound center without a physician referral but it is usually wise to keep your primary care physician in the loop.

Q. How long will it take for my wound to heal?

A: Our goal is to have a wound healed in about 4 weeks. You should plan on coming to a wound center at least weekly as wounds and the treatment changes throughout the healing process. We track the healing of your wound each week and if it is not progressing as we would like, we not only change the treatment but also try to find out what is causing the wound not to heal and hopefully prevent reoccurrence of the wound.

Q. How does diabetes actually make it difficult for wound to heal?

A: People with diabetes are at risk for developing circulatory problems, especially in their lower extremities. Wounds that have decreased circulation are more difficult to heal. Circulatory problems also lead to decreased sensitivity to the feet. Therefore, the risk of undetected injury is greater and it is important for individuals with diabetes to check his/her feet daily and have routine podiatry care.

Q. What causes venous stasis ulcers?

A: There are many valves inside our veins that, with the help of our leg muscles, return blood back to our hearts. If these valves don’t work as they should, there is pooling of blood in the veins. This pooling causes swelling and an ulcer develops. The ulcers are irregular in shape, painful and there is normally a lot of drainage. Treatment usually consists of compression wrap to assist in moving the fluid from the feet back to the heart.

Q. Is the wound center covered by insurance?

A: The short answer is “yes”. Most insurances (including Medicare and Medicaid) recognize the need for a specialty in wounds. This service helps expedite healing and reduce costs to the insurance companies. Before you come to a wound center, you can call your insurance to make sure that center is within your network. Some outpatient wound centers have a benefit-matching program that allows out-of-network benefits to be processed similarly to in-network.

Q. Can I use betadine or hydrogen peroxide on my wounds?

A: No. The Center for Wound Care does not recommend these solutions because they can kill healthy cells.

Q. Should I let my wound open to air?

A: No, wound healing best occurs when the wound bed is kept moist and the healing cells can travel across the wound to close it. The purpose of dressings prescribed for you is to maintain just the right amount of moisture, not too much and not too little. It will also protect the wound from contamination from the environment.

Q. If I get dry skin, can I use lotion?

A: Yes, skin that is kept moist is less likely to break down. But do not put skin lotion on the wound. If you have skin that is broken open, please ask the doctor for a recommended product. We suggest any kind of a lotion that is an emollient, which puts moisture back into the skin instead of covering the skin as another layer. Do not use petroleum jelly because it forms a separate layer. Examples of emollients are: Curel Moisturizing, Nivea, Neutrogena, A&D ointment, Vitamin A&D, Eucerin moisturizing, Keri lotion, and Lubriderm.

Q. What other things should I be reporting to my wound care doctor?

A: Pain from your wound; increase in drainage from your wound; high blood sugar if you are diabetic; redness in the skin around your wound; bleeding from your wound; changes in your body temperature, blood pressure or mental orientation; need for dressing supplies; any new wounds you find on your body; any changes in your medications; difficulty in completing the prescribed dressing changes; any questions or concerns you have about your wound care

Q. What is hyperbaric oxygen therapy and how does it work?

A: Hyperbaric oxygen therapy is a treatment in which the patient breathes 100% oxygen inside a pressurized chamber. The therapy quickly delivers high concentrations of oxygen to the bloodstream, assists in the healing process of wounds and is effective in fighting certain types of infections. It also stimulates blood growth of new blood vessels and improves circulation. Therapy is administered daily and the number of treatments you receive will depend on your diagnosis. Most insurances (including Medicare) do pay for this treatment and the approved indications include but not limited to: diabetic wounds of the lower extremity, chronic osteomyelitis, radiation tissue damage, skin grafts and flaps, and enhancement of healing in selected problem wounds.

Dr. Shah is Medical Director of the Methodist Center for Wound Care and Hyperbaric Medicine. The Center provides treatment for all types of chronic wounds, including offering the area’s only outpatient hyperbaric chamber.