Chronic Wound Care (Pressure Sores, Venous Ulcers, Diabetic Foot)
Chronic wound care requires a multidisciplinary approach. In the Wound Care Outpatient Clinic, specialist physicians and medical personnel evaluate the patient's wounds and decide the most appropriate treatment for them. Besides the care and dressing according to the wound characteristics, the Plastic Surgery and General Surgery departments closely follow the patient according to the wound characteristics. In wound care "Wound Care and Dressing Products" which are imported from abroad for wound care are used. Our specialist doctors determine the duration of the control according to the situation and needs of the patient and perform the necessary procedures.
What is Chronic Wound?
Late or difficult-healing wounds are called chronic wounds. Unlike acute wounds, chronic wounds have a special environment. Ischemia, hypoxia or infection are the main features of the chronic wound environment. A wound can be called a chronic wound if it does not heal within a period of three months. Chronic wounds include diabetic foot wounds, pressure sores, venous ulcers, ischemic ulcers, wounds due to various vasculitis. Chronic wounds may also develop due to soft tissue radionecrosis after radiotherapy covering soft tissue areas and extravasation of some chemotherapy drugs (leakage or discharge of fluid from a vein into tissue spaces).
The common causes of chronic wounds are obesity, smoking, malnutrition, advanced age, lack of vitamins and trace elements, malignancy, chemotherapy and radiotherapy, immunosuppressive drug use, steroid and anticoagulant use. However, a wound can become chronic without general causes. In this case, local factors that concern the wound site are mentioned. Wound healing may be delayed due to local factors such as insufficient blood flow, excessive stretching of the skin, improper closure of the surgical wound, insufficient venous drainage, presence of foreign body, presence of infection, and mobility of the wound site.
Chronic Wound Types
Chronic Wounds
Wounds that do not heal within a certain period of time and are usually recurrent are called chronic wounds. These wounds can be seen as visual evidence of an underlying condition, such as pressure on tissues, poor blood circulation or poor nutrition. Pressure sores, venous leg ulcers and diabetic foot are examples of chronic wounds. In order to treat chronic wounds successfully, the individual should be examined as a whole. In addition, very precise local wound care, understanding the wound healing process, knowledge of modern dressings, and regulating and controlling the underlying causes of the wound are required.
Diabetic Wounds (Diabetes Wounds)
Diabetes, a chronic disease, damages vascular and nerve tissues over time. Circulatory disorders in the veins cause wounds, especially in the foot area. Since opened wounds are unfortunately noticed late, wound care involves a long process. In the treatment of the wound, blood sugar should be kept under control, the injured foot should be kept up at the heart level, infection and the presence of necrotic tissues should be treated according to the wound characteristics and appropriate wound care and dressing should be performed. Treatment takes longer and requires patience. Although necessary wound care is applied during the wound healing process, retrogressions may occur.
Wounds Due to Circulatory Disorder
Diseases due to circulatory disorders such as Burger's disease and arteriosclerosis, which especially develop due to cigarette consumption, lead to occlusion of the vessels. Vein obstruction is related to leg sores; in later cases, unfortunately, it can lead to loss of feet and legs. Wounds in such diseases are usually deep and require long-term treatment.
Varicose Wounds
The main cause of these wounds, which are mostly seen in the ankle and anterior part of the leg, is the progressive varices causing blood circulation problems. Varicose veins wounds are difficult to treat and should be treated by expert opinion by the patient. These wounds should be followed up under the supervision of a physician and treated appropriately. It should be kept under medical supervision, appropriate wound dressing should be performed and if necessary, treatment should be performed by surgical intervention.
Bed Pressure Wounds
Injured / Paralyzed patients are the injuries caused by pressure on the bed or chair contact points due to lying in the same position or using a wheelchair for a long time. The resulting pressure occurs as redness and, if left untreated, may develop into growing wounds.
Wounds Due to Physical Trauma
Damage to tissues or nerves caused by external factors such as falling, crashing and stinging is physical traumas. Immediately after the trauma, the first intervention of the patient is performed by the physician in an emergency and if necessary, a surgical intervention can be performed depending on the severity of the trauma and the damage caused by the other physicians. If the specialist physician considers the wound to be treated with dressing and care after surgery or without the need for surgical intervention, it is necessary to perform the necessary care and dressing under the supervision of the doctor.
Burn Wounds
1st and 2nd degree burns are dressed daily and 2-3 days depending on the condition of the burns. The healing is directly related to the age of the patient and the condition of the wound.
Non-Closing Wounds After Surgery
If appropriate wound care and dressing is performed in the care of the wounds that develop due to the surgeries, healing is seen in 3-6 weeks. Depending on the condition of the wound, dressing is performed every day or every other day.
Wounds Treated in Chronic Wound Care Unit
In patients with chronic wounds, patients and wounds often do not meet the standards of care, so ancillary treatment methods have been developed to achieve wound healing, shorten the healing process and prevent losses. Hyperbaric Oxygen Therapy is one of these methods.
Hyperbaric Oxygen Therapy (HBO):
Hyperbaric Oxygen Therapy; It is a medical application which is given 100% oxygen and it is a treatment with oxygen at sea level, 2-3 times (usually 2.5-2.6 times) of atmospheric pressure. In other words, hyperbaric oxygen therapy is called oxygen treatment under 2.5 ATA pressure in a closed environment in order to allow the hemoglobin in the blood to take the oxygen molecules that will sustain life to the tissues more.
It has been shown in researches that the amount of oxygen in the clean blood to the tissues increases up to 20 times when 100% oxygen is inhaled under high pressure. With increasing oxygen pressure in the tissue;
Cells unable to function due to lack of oxygen are supported,
New vascular development and production of wound healing substances increase.
It prevents the growth of bacteria that grow in an oxygen-free environment and reduces the effectiveness of some toxins released by them.
Supports cells in the body's defense
It has anti-edema effect.
Reduces cell level poisoning in carbon dioxide poisoning.
37AXX
(14-Pack) Beige Self Adhesive Bandage Wrap – Breathable Self Adherent Wrap for People & Pets - Athletic Elastic Cohesive Bandage for Sports Injury: Ankle, Knee & Wrist sprains
