For Diabetics Wound Care is Essential

February 28, 2019

For those patients living with diabetes, being vigilant about wound care is extremely important according to Dr. Lisa Iucci of the Shore Wound Care Center. “Many of our patients do not have good sensation, especially in their feet so it is very important they have their feet checked. They need to have a podiatrist and in between they need to have a family member just taking a look to make sure there is no little sore or wound on their feet. Because healing for diabetics is slow and it is important for them to continually be on the lookout.”

Shore's Wound Care Center, managed by Healogics, Inc., provides specialized treatment for chronic or non-healing wounds, which are defined as sores or wounds that have not significantly improved from conventional treatments.  Associated with inadequate circulation, poorly functioning veins, and immobility, non-healing wounds lead to lower quality of life and may lead to amputations. When wounds persist, a specialized approach is required for healing.

Dr. Iucci said a recent patient to the Shore Wound Care Center came in with a wound on the bottom of his foot and told her that he had no idea there was a problem until he saw blood in the shower. “It really is a serious problem for diabetic patients.”

The doctor explained that the reason extremities, particularly feet are problematic for diabetics is because the small capillaries that feed the skin are particularly susceptible to microvascular disease. Those capillaries get calcified from the elevated level of blood sugar and they no longer feed the extremities. People will see a problem on their hands, it is the feet that present the danger of having a cut or a scratch that takes a long time to heal and can easily get infected.

That's where the Shore Wound Care Center® can help. With state-of-the-art treatments available including debridement, dressing selection, special shoes, and patient education, people with non-healing and chronic wounds now have a place to turn. The center uses an interdisciplinary model of care, including infectious-disease management, physical therapy, occupational therapy, laboratory evaluation, nutritional management, pain management, diabetes education, and other areas to address total patient health.

Dr. Iucci said there are preventative measures patients can take to keep themselves from having a chronic problem. She said that it is the Type II diabetic who is often more at risk for complications from diabetes. “Type II diabetes is diagnosed later in life and often has contributing factors like elevated blood sugar, obesity and more as contributing to the disease. Type I diabetics are often more vigilant in their diet and lifestyle because they have to be,” said Dr. Iucci. “For patients at the Shore Wound Care Center, they need to be following all of their doctor’s orders including lifestyle to allow us to help them to heal. It is also very important that diabetic patients not smoke because smoking slows the healing process. Nicotine is a vasoconstrictor that reduces nutritional blood flow to the skin, resulting in impaired healing of injured tissue.”

A patient may need to undergo vascular studies using ultrasound and doppler along with a blood pressure cuff to see the blood flow and any sites of possible arterial blockage or venous reflux. The doctor may also incorporate a lab evaluation, diagnostic imaging including MRI, and transcutaneous oxygen testing to determine the etiology of the wound.

Chronic wounds: a growing problem
It is estimated that 6.7 million people currently live with chronic wounds and that number is expected to grow over the next decade. The rising incidence is fueled by an aging population and increasing rates of diabetes, obesity and the late effects of radiation therapy. Untreated chronic wounds can lead to diminished quality of life and possibly amputation of the affected limb. In the United States alone there are more than 29 million people with diabetes and nearly 2 million will develop a diabetic foot ulcer or other non-healing wound. Dr. Iucci said that advanced wound care aims to treat other non-healing wounds as well, prevent amputations and heal patients in a faster, more cost-effective way and improve the patient’s quality of life. At Shore's Wound Care Center treatment protocols specifically established for each type of wound utilizing the latest approaches to wound healing and remain current in new scientific advances in wound care.

Patients are mostly referred by their primary care physician. They will undergo a thorough diagnostic examination to identify the type of wound they have and the underlying problems causing the wound. The initial appointment consists of a full assessment to determine the etiology of the wound, the appropriate classification and size of the wound, the overall health status of the patient and the patient’s ability to comply with needed therapies. From there a customized treatment plan will be developed to best suit the patient’s needs.

What is specialized wound care?
Once a treatment plan has been initiated, you will visit the Shore Wound Care Center on a regular basis for specialized treatments and documentation of the progress of your healing. You will also be fully instructed on how to do your own wound care at home between visits, as well as how to protect your wound from further injury.  It is very important to remember that you are the most important part of your healing process.  Keeping appointments and following directions are critical to attaining a positive healing outcome. The Center employs the most technologically advanced wound care therapy, including debridement, topical wound therapy, growth-factor therapy, tissue therapy, dressing selection, special shoes, and patient education.  When wounds persist, a specialized and comprehensive approach is required for healing.

Dr. Iucci said it is a great feeling to be able to discharge a patient. “When someone has come to us with a chronic problem and a wound that will not heal, it is something that really interferes with their life. Once we solve their problem and they are discharged, I am very happy they are able to go back to their lives. We just need to make sure they understand how important it is for them to continue to be vigilant and follow their doctor’s orders, take their meds and keep their blood sugar in check.” Specialized wound care is usually administered on an outpatient basis.

To see Dr. Lisa Iucci or to make an appointment at the Shore Medical Center’s Wound Care Center, located on the second floor of the hospital at 100 Medical Center Way, Somers Point call 609-653-4526. The center is open 8 a.m. to 4:30 p.m. Monday through Friday.