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When Wounds Won't Heal

August 09, 2005

   Most of us take our body’s ability to heal for granted. During normal wound healing, the body produces new cells and blood vessels in an orderly, predictable course. The process depends on the availability of a good blood supply and various essential nutritional elements.

   The wound-healing process is complicated, though. For some patients, various factors such as circulatory problems, diabetes and infection can derail the healing process and their wounds become chronic. The Outpatient Wound Care Clinic at Washington Hospital specializes in determining why such wounds aren’t healing and what treatment is required to promote faster healing and avoid further complications.

   Since the clinic opened in March, the number of patients seeking such specialized wound care has increased dramatically, notes plastic and reconstructive surgeon Dr. Prasad Kilaru, the clinic’s medical director. "We’re currently seeing about 20 patients per week," he says. "Many of our patients are Fremont residents who used to have to travel to San Jose for treatment. We are the only specialized wound care clinic between San Jose and Oakland."

   Kilaru points out that many of the clinic’s patients are elderly. "We’ve had several older patients who developed pressure ulcers - sometimes called bed sores - and we’ve been able to treat their wounds effectively and help them avoid hospitalization or transfer to nursing homes," he says. "Older people also are more likely to have diabetes, and at least half of our patients are diabetic. We work with them to control their diabetes, which can impede wound healing, by providing dietary recommendations and various exercises to increase their mobility and improve blood circulation."

   The wound-care experts at the clinic work in cooperation with their patients’ primary care physicians to provide advanced treatment technologies tailored to the specific needs of each patient. The multi-disciplinary team includes plastic and reconstructive surgeons, podiatrists, vascular surgeons, infectious disease physicians and nursing specialists with specific training in wound treatment. In addition, the clinic provides physical therapists, dietitians, diabetes educators and pain management specialists.

   "It is truly a team effort, with an emphasis on treating the ‘whole patient,’ not just a specific wound," Kilaru explains. "For example, the vascular surgeon and I recently were able to detect a patient’s vascular disease and perform surgery to correct the problem and prevent a possible stroke. By improving the patient’s blood circulation, we also promoted faster wound healing."

   Kilaru notes that while the standard definition of a "chronic wound" is one that has not healed within six weeks, the clinic will evaluate any patient who has a troublesome wound. Patients who have risk factors such as diabetes should not hesitate to consult a physician if they have wounds that appear to be getting worse, rather than better, even if the wound is only a week old.

   Washington Hospital’s Outpatient Wound Care Clinic currently offers appointments on Monday mornings and Thursday afternoons. "We are hoping to expand our clinic hours in the near future, when we are able to contract the services of more physicians and other care providers," Kilaru says.

   The clinic is located at 1900 Mowry Avenue in Fremont, adjacent to Washington Hospital. For more information, or to schedule an appointment, call (510) 608-3290.