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Prakash Chandran (Host): When we think of treating wounds, we imagine applying a bandage or possibly stitches or deeper injuries. But at Harrington Hospital, there’s actually a Wound Care Center that treats all types of wounds including nonhealing ones. Let’s talk with Heather Sienel, a Physician Assistant at Harrington Hospital’s Wound Care Center.

This is Healthy Takeout, the podcast from Harrington Hospital. I’m Prakash Chandran. So, Heather, what exactly is a Wound Care Center anyway?

Heather Sienel, PA (Guest): A Wound Care Center is a place where we can actually treat patients that have more complicated wounds, things such as surgical wounds that don’t heal or people who may have things like peripheral vascular disease or swelling in their legs caused by what’s called venous hypertension and those are conditions that can make it so your wound does not heal and can actually get really infected.

So, here at the Wound Care Center, we have the ability and all of these really neat dressings that we can put on wounds to help them heal faster and help the patients get back to their lives.

Host: Okay and just to be clear. I cut myself or let’s say it’s a pretty severe gash, that’s something that you’re saying that I would probably take care of myself, you handle more complex wounds. Is that correct?

Heather: No actually, we handle gashes, we handle people who just get sutures in place. We handle people who’ve had like abscesses that they’ve had to go and get drained. We pretty much can take care of any wound possible.

Host: Any wound possible. And so I’m imagining listening to this as a layman, when I cut myself pretty deeply, I think what I would normally do is I’ll put like Neosporin on it, I’ll try to put a Band-Aid on, if it’s more severe, I would just rush to the hospital. Are those the right steps to prep before coming to see you at the Wound Care Center?

Heather: if you cut yourself and you are bleeding, then you probably need stitches. If that’s the case; then you should go to an Urgent Care or you should go to the Emergency Department where they will suture the wound or stitch the wound and they will do x-rays to make sure that everything underneath, if it’s on your hand or your leg, is okay. After that happens, you can come and see us as opposed to going to your primary care physician and we can take the stitches out. Not only that, but we can watch the wound to make sure it’s healing okay, to make sure those two edges that they stitched together stayed together and to also make sure it doesn’t get infected.

Host: Okay and so let’s say I get stitches. I mean at what point do you separate oh don’t worry you’re fine, let it heal on its own versus no you should really come to the Wound Care Center so we can monitor this type of stitch? Like how do you separate those two things?

Heather: I would say that if you are a young, healthy individual and you were out skateboarding and you cut yourself, that wound should heal in two weeks. If you are say somebody who is more on the mature side and you get a big gash; then you should come see us sooner rather than later. Anybody that’s got vascular issues in their legs, such as the arteries are not pumping like they should; they get swelling, diabetics is another one where we would probably see the wound sooner rather than later. And I would say that would be within the first week of getting the wound. But otherwise, if you are a young, healthy individual, the wound should heal in two weeks or healthy individual, I should say.

Host: Got it. So, maybe talk about some of the most common things that you see there at the Wound Care Center and how you treat the wounds.

Heather: Some of the most common wounds that we see, we see a lot of wounds that have to do with swelling in your legs. They’re called venous ulcers. We see a lot of patients that have what’s called lymphedema ulcers and arterial ulcers and all of those have to do with the circulation in your legs. Either the circulation gets backed up and you get really swollen and then what happens is the body is trying to find a way for that fluid to get out, so it tends to breakdown the skin and you get what’s called venous ulcers.

Arterial ulcers means that there’s not enough blood supply to heal the wound that you had. Say you dinged it on a door and it just gets bigger. We see a lot of those too. We see a lot of gashes or open wounds from people hitting themselves on a door to people dropping air conditioners on them to people falling off bikes or getting hit by cars and then they have a big open wound that they need help healing. We see all of those too.

So, anything from trauma to people who have issues with circulation in their legs. I’d say those are the most common ones we see.

Host: I’ve heard of this concept of a nonhealing wound before. I think you kind of alluded to it as you were talking earlier. But maybe talk a little bit about what causes a nonhealing wound.

Heather: Nonhealing wounds can come depending on where they are, can come from anything to you are a sick person and say you have to go on what’s called immunosuppressants which are medications that make your immune system not work very well to people who smoke because smoking is very bad for healing, among other things to other people who are not able to get enough protein in because protein helps give your body the building blocks it needs to heal to people who can’t seem to if they are a paraplegic or can’t move their limbs and they tend to be able to stay in one spot. That’s very difficult to heal too.

Or people who just can’t seem to get – they can’t get the blood flow to the wound, then those will be very difficult to heal as well. So, that would be – so a nonhealing wound is something that we look at that’s about six weeks out. Not to say that we have not healed wounds that are older than six weeks, but the further out you get from the wound to not healing; the harder it gets to heal.

Host: And let’s talk about some of the treatments that you use. I’m imagining that you monitor the wound, you clean it, you make sure that basically nature is running its course and it’s healing properly, but are there things that you can do at the Wound Care Center to accelerate the healing?

Heather: So, we have lots of really cool treatments here. And it might just be because I think wounds are amazing, but I think that we have a lot of wonderful things and really cool treatments that we can put on wounds to help them heal faster. We have what’s called skin substitutes and they take them from various things like some of them are baby cows, some of them are like umbilical tissue and what we do is we can put it in the wounds, and it helps give them the cells that they need. It’s almost like stem cells in terms of healing. So it kind of like jump starts. They put these baby cells in and they can heal the wounds.

And then we have other dressings that have collagen in it and collagen is the building blocks that you need to heal a wound. Think of it like you are a mason and now we just put the concrete in your wound and it’s going to start building up the clocks to heal it. And the other thing is we have different kinds of dressings that help take away moisture if there’s too much moisture in a wound from swelling. And some of those have antibiotics impregnated into them so that if we can help kill the bacteria that are in them while taking away the moisture. And we have wraps that can help make you skin really nice and help heal the skin around it.

We have, oh my goodness, we have so many cool things. And we have all different kinds of things too.

Host: Yeah, you definitely do and in doing some research, I also heard about this thing called hyperbaric oxygen therapy which sounds like it is something from the future. So, maybe you can talk a little bit about that.

Heather: It does look a little bit like from the future but again, hyperbaric oxygen is – what it is, is we have two chambers here. Their names are Boris and Natasha. They do have names. What it is, is it’s the pressure and oxygen as a prescription to help heal wounds. What is does is we add oxygen to your body so that the cells can take that oxygen to the wound and help it heal faster. The other is it’s really good for diabetics who get like the ulcers and the wounds on their feet that are really hard to heal. Because diabetics are prone to get some really, really nasty bacteria. That type of bacteria does not live very well in oxygen rich environments. So, when we put them in our chambers, they have really nice TVs and are actually really relaxing; then the oxygen rich environment makes it so that the bacteria that live in that ulcer cannot live anymore. So, it cause them to die.

Host: What do you wish that more people knew about wounds before they came to see you at the Wound Care Center?

Heather: I wish that more people knew that pathology that was going on behind the wounds and the things that inhibit wound healing and so came to see us sooner so that we can help the wounds heal before they get infected or before they try and do it themselves by covering it with Neosporin and just slapping a Band-Aid on it because wounds are so much more than that. There are so many different factors and components and things that go into the healing process as opposed to just I’m just going to put a Band-Aid on it, and it’ll be better.

Host: Right so, everyone listening, even though you think you can just fix it with a little Neosporin, it’s better to be safe than sorry. Go to your Wound Care Center, that’s why they exist, right Heather?

Heather: Come and see us sooner rather than later and even if it’s a one time visit, at least we can kind of get a handle on it early and get them healed.

Host: All right Heather. Well we really appreciate your time today. That’s Heather Sienel, a Physician Assistant at Harrington Hospital’s Wound Care Center. Thanks for checking out this episode of Healthy Takeout. Head to www.harringtonhospital.org to get connected with Heather Sienel or another provider. If you found this podcast helpful, please share it on your social channels. That would really help us out. And be sure to check out the entire podcast library for topics of interest to you. Thanks and we’ll see you next time.