When a Band-Aid just won’t do
"It all started when I rubbed a little bump on the ball of my right foot," says Stanley Reeves, who has diabetes. "I didn't think it was a big deal." But, it was a big deal.
"People with diabetes should always see their doctor when they have a cut or wound, no matter how small it is. The slightest tear in the skin can lead to serious infection, or even the loss of a limb," says foot and ankle specialist Christopher LaRosa, DPM
, medical director of Virtua Health's Wound Healing Center.
The "little bump" on Reeves' foot was an infected diabetic ulcer that wouldn't heal. Self-treating it made the infection worse. Within days, Reeves was hospitalized at Virtua Berlin Hospital, where he underwent several procedures to save his foot. "Like most people with diabetes, Mr. Reeves has damage to the nerves in his legs and feet, meaning he didn't feel enough pain to know just how serious the wound and infection had become," says Dr. LaRosa.
Reeves' recovery was complicated by peripheral vascular disease, a narrowing of the blood vessels in the lower extremities, which also is common in those with diabetes. As part of his treatment, physicians performed angioplasty, stenting and bypass surgery in his leg to increase blood flow to his foot for healing.
"For people with diabetes, non-healing wounds are only part of a very complex picture. This disease affects all of the body's major systems," says Dr. LaRosa. "That's why we take a unique, interdisciplinary approach to treatment," he says. Other wounds that may require special treatment include pressure ulcers, traumatic injuries and surgical incisions that are slow to heal.
The wound-care team is made up of a variety of specialists who offer comprehensive care. This includes physical therapists, nutritionists, registered dietitians, advanced practice nurses, endocrinologists, infectious disease specialists, and a variety of surgeons, including foot and ankle, plastic, vascular and general surgeons.
Based on the patient's needs, the team creates an individual wound management plan that may include special dressings and pressure relief, nutritional support, pain management, diabetes education, infection control and a range of other treatments. Because the center is affiliated with an acute care center, patients can receive care all in one place.
Dr. LaRosa and his team were able to save Reeves' foot. "Now it's up to me to stay off it as much as possible," he says.
"Complying with treatment plans can be difficult for patients," says Dr. LaRosa. "Diabetes completely changes their lives. Add to that a crisis like a non-healing wound, and patients and their families can feel extremely hopeless. We're here to support them, 24 hours a day, seven days a week."
World-class care where you least expect it
Nestled on the campus of Virtua Berlin is the state-of-the-art Wound Healing Center, where Tim R. of Haddon Township receives treatment for a bone infection in his foot. "You would normally associate this kind of facility with a university medical center in a major city," he says.
The center offers comprehensive wound care and prevention services. "Patients and their primary care physicians are responding positively to our unique treatment model," says certified wound nurse and manager at the center, Kathleen Judge, MSN, APRN, BC, CWOCN. "We're seeing patients from as far away as the shore, Central Jersey and even Pennsylvania.
At Virtua's Wound Healing Center, patients benefit from the relaxed comfort of an outpatient facility with all the resources of an acute care center, such as hyperbaric oxygen therapy.
Judge explains that sufficient oxygen levels are key to healing serious wounds. By using slightly higher than normal air pressure, hyperbaric oxygen chambers allow patients to breathe in a greater amount of pure oxygen than they would by breathing regular air. This helps improve blood supply, which in turn generates healthy tissue, resulting in faster, deeper wound healing.