Millions of people suffer needlessly from chronic, non-healing wounds — such as those caused by diabetes, poor circulation, injuries and other conditions.
Most wounds can be treated successfully by a primary care physician. However, when wounds have not healed after several weeks, they may require specialized care. The Inland Valley Wound Care Program offers advanced treatment options for chronic wounds.
Listen as Dr. Mazin Khateeb, MD, the Medical Director of Wound Care at Southwest Healthcare System, discusses non healing wounds and when you should consult a specialist to achieve the best possible healing outcomes.
Selected Podcast
Help for Non Healing Wounds
Featured Speaker:
Mazin Khateeb, MD
Mazin Khateeb, MD is the Medical Director of wound care at Southwest Healthcare System. Transcription:
Help for Non Healing Wounds
Melanie Cole (Host): Millions of people suffer needlessly from chronic, nonhealing wounds such as those caused by diabetes, poor circulation, injuries, and other conditions. Most wounds can be treated successfully by a primary care physician, however, when wounds that have not healed after a certain amount of weeks may require specialized care. My guest today, is Dr. Mazin Khateeb. He’s the Medical Director of Wound Care at Inland Valley Medical Center, part of Southwest Healthcare System. Welcome to the show, Dr. Khateeb
Dr. Mazin Khateeb (Guest): Thank you.
Melanie: When a wound does not heal – if someone notices this – how long should they wait before they see somebody about this wound?
Dr. Khateeb: It varies, but the most important thing is they shouldn’t wait more than two to three weeks. Being treated by the primary care, or other physicians or providers, they should seek wound center care right away.
Melanie: What should – especially people like diabetics – be looking for in a wound that would signal that there’s something wrong, that there’s something that they shouldn’t like because people have many misconceptions about whether or not a wound is infected or if it’s nonhealing? What are some red flags, Dr. Khateeb, things they should look for in a wound?
Dr. Khateeb: If the wound is draining, for example, pus or even if there is a yellowish tissue on top of It, which indicates that it needs to be cleaned and it needs to be debrided. The other thing is if they get any redness, swelling around the wound, for example, in the foot, and if they get, of course, fever, that’s all signaling that they need to be looking for care.
Melanie: There’s a type of therapy available now called Hyperbaric Oxygen Therapy. Tell the listeners what that is, Dr. Khateeb, and what’s involved.
Dr. Khateeb: Yes, Hyperbaric Oxygen is a chamber with a clear covering – you can see through it very easy. We put the patient there only with a special indication. Not everybody can benefit from this, and there are four or five indications, i.e. infection in the bone, radiation necrosis, and stuff like that. What this entails is that after the patient is put in the chamber and it’s locked it’s very similar to you going on an airplane and it gets pressurized. Basically, they put pressure in the chamber, and all the patient will feel maybe the ears popping. They pump 100% oxygen there, and that will increase oxygen going into the tissues, especially the wound or the injured place, and that will really promote healing. We do that an hour and a half or 90 minutes every day during the week, not the weekends. Usually, we prescribe maybe 20 to 30 sessions.
Melanie: How soon would somebody see results from HBOT?
Dr. Khateeb: After from being in the Hyperbaric Oxygen Chamber after maybe 20 or 30 sessions, that should show some results. We have seen it happening, very, very good results.
Melanie: So do people get nervous or claustrophobic? Tell us about the chamber itself.
Dr. Khateeb: The chamber itself is actually not that tight. It’s not like going to the MRI or CT scan, but still, some patients they feel claustrophobic or nervous. We give them some pills to sedate them and relax them. While they are in the hyperbaric chamber, there’s always a TV monitor where they can watch all kinds of movies there while they are in the chamber. And then, also, inside the chamber, there’s always a technician supervising, and then I will be personally also supervising. I have to be physically in the center when diving happens – that’s what we call it, diving.
Also, when they are in the chamber, they can communicate through a microphone while they are laying down there. We put all 100% cotton because polyester creates static and that’s very dangerous in the presence of oxygen. Everything has to be special from the sheets to the gown to everything. They are not supposed to carry anything inside except maybe a little bottle of water.
Melanie: Is there any information that the technician needs to know from the patient prior to HBOT? Do you want to know if they’re not feeling well that day, if there’s been a change to their medication, or if they’ve eaten? Is there anything that you want patients to specifically relay before they go in?
Dr. Khateeb: Definitely. Before they go in the staff here, they check the vital signs to see their blood pressure, their heart rate, and so on and so forth. Also, with diabetics, we check their sugar before and after Hyperbaric Oxygen. If it’s below a certain level – especially if it’s below a certain level before therapy, we give them sugar or juices to build it up. We recheck it, and if it’s at an acceptable level, then we dive them.
The other thing is we check their ears to make sure they don’t have any blockage or congestion. Although, sometimes we do all of this and then when we dive them they have pain, and when that happens, we stop therapy, and we refer them to ear, nose, and throat specialist. They may end up sometimes with the insertion of a little tube in the ear to make it easier for them. And then, after they have that, they come back to us, and we dive them with no problem.
Melanie: And before we wrap up, Dr. Khateeb, what would you like people to know about wounds, about keeping that wound – do you want people – because people do not know whether it should be moist and covered, or air dry. People hear all of these different things. What is the most important bit of information you would like to relay about wounds and taking care of them?
Dr. Khateeb: Definitely if we’re talking about wounds of the feet – especially the sole of the feet – but in general, if a wound is wet then we have all kinds of products here in the wound care – different than what they have in the hospital. We use those to dry it. If it’s dry – completely dry, we try to moisten it also with some ointments and medications, and we put them on antibiotics. Usually, routinely, when the patient comes here, we treat them – once a week we have to see them on follow-up. We have a very good healing rate. It’s almost 97%.
Melanie: And why should they come to Southwest Healthcare System for their care?
Dr. Khateeb: No because I’m the Medical Director here, but my background – I’m a general surgeon in the past. I have worked quite a few wound care centers, and honestly, this is the best I have seen. I’m talking about the staff, the RNs, technicians, CNA, all of them are great people, and the know what they are doing. We care a lot about the patients, and we address even – I say address, I mean we point out if they have, for example, uncontrolled diabetes, uncontrolled hypertension, then we advise them strongly to go back to their primary to seek treatment.
And also, I just remembered, we’re talking about what to advise patients with wounds. There are wounds on the sole of the foot – very important. We use this term off-loading, which means they have to stay off walking on it because regardless what we do if the patient walks on it and that’s what puts pressure, it will never heal. We take care of all of that and high rates of patient satisfaction. I really think this is the center of excellence, actually.
Melanie: Thank you, so much, Dr. Khateeb, for being with us today. You’re listening to Southwest Health Talk with Southwest Healthcare System, building relationships that touch the heart. For more information, you can go to SWHealthcareSystem.com, that’s SWHealthcareSystem.com. Physicians are independent practitioners who are not employees or agents of Southwest Healthcare System. The hospital shall not be liable for actions or treatments provided by physicians. This is Melanie Cole. Thanks, so much for listening.
Help for Non Healing Wounds
Melanie Cole (Host): Millions of people suffer needlessly from chronic, nonhealing wounds such as those caused by diabetes, poor circulation, injuries, and other conditions. Most wounds can be treated successfully by a primary care physician, however, when wounds that have not healed after a certain amount of weeks may require specialized care. My guest today, is Dr. Mazin Khateeb. He’s the Medical Director of Wound Care at Inland Valley Medical Center, part of Southwest Healthcare System. Welcome to the show, Dr. Khateeb
Dr. Mazin Khateeb (Guest): Thank you.
Melanie: When a wound does not heal – if someone notices this – how long should they wait before they see somebody about this wound?
Dr. Khateeb: It varies, but the most important thing is they shouldn’t wait more than two to three weeks. Being treated by the primary care, or other physicians or providers, they should seek wound center care right away.
Melanie: What should – especially people like diabetics – be looking for in a wound that would signal that there’s something wrong, that there’s something that they shouldn’t like because people have many misconceptions about whether or not a wound is infected or if it’s nonhealing? What are some red flags, Dr. Khateeb, things they should look for in a wound?
Dr. Khateeb: If the wound is draining, for example, pus or even if there is a yellowish tissue on top of It, which indicates that it needs to be cleaned and it needs to be debrided. The other thing is if they get any redness, swelling around the wound, for example, in the foot, and if they get, of course, fever, that’s all signaling that they need to be looking for care.
Melanie: There’s a type of therapy available now called Hyperbaric Oxygen Therapy. Tell the listeners what that is, Dr. Khateeb, and what’s involved.
Dr. Khateeb: Yes, Hyperbaric Oxygen is a chamber with a clear covering – you can see through it very easy. We put the patient there only with a special indication. Not everybody can benefit from this, and there are four or five indications, i.e. infection in the bone, radiation necrosis, and stuff like that. What this entails is that after the patient is put in the chamber and it’s locked it’s very similar to you going on an airplane and it gets pressurized. Basically, they put pressure in the chamber, and all the patient will feel maybe the ears popping. They pump 100% oxygen there, and that will increase oxygen going into the tissues, especially the wound or the injured place, and that will really promote healing. We do that an hour and a half or 90 minutes every day during the week, not the weekends. Usually, we prescribe maybe 20 to 30 sessions.
Melanie: How soon would somebody see results from HBOT?
Dr. Khateeb: After from being in the Hyperbaric Oxygen Chamber after maybe 20 or 30 sessions, that should show some results. We have seen it happening, very, very good results.
Melanie: So do people get nervous or claustrophobic? Tell us about the chamber itself.
Dr. Khateeb: The chamber itself is actually not that tight. It’s not like going to the MRI or CT scan, but still, some patients they feel claustrophobic or nervous. We give them some pills to sedate them and relax them. While they are in the hyperbaric chamber, there’s always a TV monitor where they can watch all kinds of movies there while they are in the chamber. And then, also, inside the chamber, there’s always a technician supervising, and then I will be personally also supervising. I have to be physically in the center when diving happens – that’s what we call it, diving.
Also, when they are in the chamber, they can communicate through a microphone while they are laying down there. We put all 100% cotton because polyester creates static and that’s very dangerous in the presence of oxygen. Everything has to be special from the sheets to the gown to everything. They are not supposed to carry anything inside except maybe a little bottle of water.
Melanie: Is there any information that the technician needs to know from the patient prior to HBOT? Do you want to know if they’re not feeling well that day, if there’s been a change to their medication, or if they’ve eaten? Is there anything that you want patients to specifically relay before they go in?
Dr. Khateeb: Definitely. Before they go in the staff here, they check the vital signs to see their blood pressure, their heart rate, and so on and so forth. Also, with diabetics, we check their sugar before and after Hyperbaric Oxygen. If it’s below a certain level – especially if it’s below a certain level before therapy, we give them sugar or juices to build it up. We recheck it, and if it’s at an acceptable level, then we dive them.
The other thing is we check their ears to make sure they don’t have any blockage or congestion. Although, sometimes we do all of this and then when we dive them they have pain, and when that happens, we stop therapy, and we refer them to ear, nose, and throat specialist. They may end up sometimes with the insertion of a little tube in the ear to make it easier for them. And then, after they have that, they come back to us, and we dive them with no problem.
Melanie: And before we wrap up, Dr. Khateeb, what would you like people to know about wounds, about keeping that wound – do you want people – because people do not know whether it should be moist and covered, or air dry. People hear all of these different things. What is the most important bit of information you would like to relay about wounds and taking care of them?
Dr. Khateeb: Definitely if we’re talking about wounds of the feet – especially the sole of the feet – but in general, if a wound is wet then we have all kinds of products here in the wound care – different than what they have in the hospital. We use those to dry it. If it’s dry – completely dry, we try to moisten it also with some ointments and medications, and we put them on antibiotics. Usually, routinely, when the patient comes here, we treat them – once a week we have to see them on follow-up. We have a very good healing rate. It’s almost 97%.
Melanie: And why should they come to Southwest Healthcare System for their care?
Dr. Khateeb: No because I’m the Medical Director here, but my background – I’m a general surgeon in the past. I have worked quite a few wound care centers, and honestly, this is the best I have seen. I’m talking about the staff, the RNs, technicians, CNA, all of them are great people, and the know what they are doing. We care a lot about the patients, and we address even – I say address, I mean we point out if they have, for example, uncontrolled diabetes, uncontrolled hypertension, then we advise them strongly to go back to their primary to seek treatment.
And also, I just remembered, we’re talking about what to advise patients with wounds. There are wounds on the sole of the foot – very important. We use this term off-loading, which means they have to stay off walking on it because regardless what we do if the patient walks on it and that’s what puts pressure, it will never heal. We take care of all of that and high rates of patient satisfaction. I really think this is the center of excellence, actually.
Melanie: Thank you, so much, Dr. Khateeb, for being with us today. You’re listening to Southwest Health Talk with Southwest Healthcare System, building relationships that touch the heart. For more information, you can go to SWHealthcareSystem.com, that’s SWHealthcareSystem.com. Physicians are independent practitioners who are not employees or agents of Southwest Healthcare System. The hospital shall not be liable for actions or treatments provided by physicians. This is Melanie Cole. Thanks, so much for listening.