LONDON In a medical climate where specialized care is increasingly the norm, it might come as some surprise that there is no subspecialty for wound care. That doesn’t change the fact, however, that wound care centers are, in fact, providing specialized care.
“We have the tools to help what I call the forgotten population,” says Mary Ann Payne, BSN, RN, clinical nurse manager at the Wound Care Center at Saint Joseph London. “They aren’t sick enough to be in the hospital. Sometimes they are still driving and still working, so they can’t get home health. So here we are.”
The “here” is important. The Wound Care Center, which opened in October 2018, serves what program director Matthew Lawson estimates as a 40-mile radius. Because of the lack of wound care in the area, there was confidence that there was an adequate patient population to justify opening the Center. In the first six months of the Center’s operation, the response has more than verified that expectation.
“The growth has been impressive,” Lawson says. “The projections were less than what we are doing right now. We were projected to have 18 new patients for the month of February, and we were at 26. We are averaging about 40–50 patients per week, and the projected growth potential is about 80–90 per week.”
The Center’s rapid early growth is due in part to hard work, visiting 90–100 area providers per month to make them aware of the Wound Care Center. It is also due to the needs of the local population. “The need was obvious,” says Lawson. “A lot of our patients have foot ulcers. Podiatrists, infectious disease physicians, and general surgeons, up until now, have been dealing with those the best they could. From there, they would go to Lexington or Somerset to receive hyperbaric therapy or alternative wound care. The patient population is what drove it; this area and this population, it was ideal for this center.”
“I feel like wound care patients are the forgotten population. Wound care is not a medical subspecialty.”— Mary Ann Payne, RN, clinical nurse manager, Wound Care Center at CHI Saint Joseph Health in London.
The staff’s eagerness to see the Center grow comes from their desire to help those in need. The high rates of diabetes, obesity, and smoking in the area contribute to common patient presentations of venous and foot ulcers. Some patients deal with those wounds for years. The Wound Care Center is working to change that. “I feel like we should be growing even faster because of our population,” Payne adds.
“We have patients who have had wounds for quite some time,” says Kimberly Cesario, APRN, who serves as the Center’s primary care provider. “Those wounds almost take over their life. We work through the process with them. It may take a few weeks to a couple months, and then we finally heal it. To watch a patient heal is the most rewarding thing.”
Because of the complexity and longevity of some of the wounds treated at the Wound Care Center, the diagnostic process can resemble investigative work. So far, the Center has been highly successful, recording a 98 percent heal rate to date.
Serving the Local Patient Population
“We have a lot of diabetic patients and obesity in the area,” says Jean-Maurice Page, MD, who serves as the medical director of the Wound Care Center in addition to his practice with CHI Saint Joseph Medical Group – Orthopedics. “These patients present a special challenge with their wounds. They are very slow to heal. The treatment is different than an acute wound. They are infected, so you don’t stitch it. You need to heal it from inside out. The patient needs to be compliant, or they’re not going to heal. But it’s proven that a wound care center can decrease the rate of amputation by more than 50 percent.”
Cesario says that collaboration with local physicians and families plays an essential role in the patient’s success.
“We are here to work with primary care providers, to collaborate with them, to help their patients achieve healing,” Cesario says. “We offer techniques and technologies that the primary care office might not be able to do, and we have the ability to see the patient on a more frequent basis than a busy primary care practice typically can.”
Patients generally have weekly visits at the Wound Care Center to monitor the healing process and make any necessary adjustments. If the patient isn’t responding to the treatments, one of those potential adjustments is the Center’s hyperbaric oxygen chamber.
“To have this kind of technology in London is just amazing to me,” Payne says, noting that hyperbaric chambers have been proven to dramatically speed up the healing process by forcing highly oxygenated blood to all areas of the body, including the wounded area.
“If we bring a patient in for a month and we’re not seeing any progression and there’s proper profusion, the hyperbaric chamber is ideal for them,” Lawson says, noting the chamber’s 93 percent heal rate. “We had one patient scheduled for 20 treatments. After 10 visits, the wound went from a pencil-sized ulcer that ran all the way to the bone to where it looks like a paper cut now. That was our first hyperbaric patient. It was shocking to us. We knew it was a benefit, but until you see it, you can’t believe it.”
After years of dealing with chronic wounds, many of these patients may have forgotten what it feels like to be healthy. Thanks to the Wound Care Center, these patients are forgotten no longer.