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Treatments for Hard to Heal Wounds
Chronic or hard-to-heal wounds can greatly affect your quality of life. They are often caused by trauma, burns, infections, or by underlying conditions such as diabetes. In this podcast, wound expert Dr. Sherif Osman addresses why these wounds are hard to heal and the treatment options available.
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Learn more about the Center for Wound Care at UM UCH
Sherif Osman, MD, CWS, FAPWCA
Sherif Osman, MD, CWS, FAPWCA, is the medical director of the Center for Wound Care at UM Upper Chesapeake Health (UM UCH) and a physician who specializes in wound care and internal medicine. He attended the University of Cairo Faculty of Medicine and completed his residency at Polyclinic Medical Center in Harrisburg, Pennsylvania. Dr. Osman serves as the medical director for the Center for Wound Care at UM UCH and has been named a “Top Doctor” by Baltimore magazine in the specialty of Alternative, Complementary and Naturopathic medicine. He is a certified wound specialist and a fellow of the American Professionals Wound Care Association.Learn more about Dr. Osman
Learn more about the Center for Wound Care at UM UCH
Transcription:
Treatments for Hard to Heal Wounds
Evo Terra: Welcome to the Live Greater podcast series, information for a Healthier You from the University of Maryland Medical System. Im Evo Terra. At some point in time, you've probably had a wound, a cut finger that was fixed with a simple bandage or something that required stitches like a surgical procedure, and it probably healed fine, but that's not always the. To help understand how to treat hard to heal wounds.
Today I'll talk with Dr. Sherif Osmam, md. He's a medical director at the University of Maryland Medical System. Dr. Osmam, welcome to Live Greater.
Dr Sherif Osmam: Hi there.
Evo Terra: So, what makes a wound hard to heal and what, what qualifies as that word hard to heal?
Dr Sherif Osmam: we classify as wounds, as chronic wounds or problem wounds. These wounds are wounds that fail to heal as we would expect any wound to heal , when anyone be develops a wound. It goes through different stages of healing starting from the stage where the blood clots and the wound starts to seal all the way to when the wound becomes completely healed In scar tissue forms any of these when did disruptive, can result in a wound that fails to heal and becomes chronic.
Evo Terra: So what do we do with wounds? What do you do with wounds, I guess I should ask that won't heal? How are they typically treated
Dr Sherif Osmam: So oftentimes, these wounds that I see have already been seen by other physicians and have failed to heal. They've often been treated with antibiotics or surgery, and despite that, they've continued to be problematic. So the first thing that I do is try to determine the reasons for the wound not healing. The most common problem wounds occur after surgery where there's dehiscence, which means the wound fails to heal and reopens or after radiation or after burns or after wounds that develop in patients who are diabetic or patients with poor circulation. Autoimmune diseases often results in wounds that fail to heal. patients that are malnourished or have cancer chronic edema in the legs. I mean, swelling is a big problem for patients who have venous insufficiency in varicose veins. And sometimes I even see animal bites.
Evo Terra: Wow. Sounds like there's a lot of things that can cause this. One thing I know will never cause it though is having a mole removed from your back on your shoulder area and getting stitches in it, and then going out to play golf two days later that would never cause this problem. He said from experience ,
Dr Sherif Osmam: actually, I've seen this problem quite a number of times.
Evo Terra: I've seen it once and that was enough for me. I don't wanna do any more of that. Oh, well, let's talk about this for a second. I mean, there are lots of things where I want to get to, but clearly if we've got a wound that's not healing, people can't be with their doctor all the time. They have to somehow dress and treat this wound on their own. How often should we be changing dressings on a wound that cannot be healed?
Dr Sherif Osmam: Well, first of all, besides determining the cause of the wound, if there's any dead tissue that is on the wound, that's one of the first things that has to be removed the dead tissue a attracts bacteria and infection and causes inflammation, which. Results in poor. So we do things like surgical debridement, which means removing the dead tissue, . And then we use specific specialized topical antibacterial dressings. these dressings over the last 10 to 20 years have become very sophisticated and are impregnated with things like ionized silver and other antibacterial products. That kill bacteria without harming the growth that occurs on the wound. And these dressings can typically last anywhere between a couple of days, all the way up to seven days. And all that depends on the amount of fluid discharge from the wound. And so the more fluid, the more frequently the dressing needs to be changed.
Evo Terra: Right. . One thing that strikes me as we, we're talking about this, is I'm assuming that there might be people out there listening right now who are thinking, Hey, I've just had surgery. I've got this incision, or I just had this thing happen to me. It it, is there something we should be doing if we do have a wound so that we could do to maybe facilitate faster healing or something to prevent a wound from becoming hard to.
Dr Sherif Osmam: Well, most surgical wounds and acute wounds heal just fine. And oftentimes, the treatment that's prescribed by the surgeon who performs the procedure is more than adequate to heal. The overwhelming majority of wounds is these subtypes of wounds that result in poor healing. Like I said, require more attention. And the key is to determine what is the cause in a diabetic patient. It could be uncontrolled diabetes. Or it could be an an infection that requires antibiotics. The key is keeping the wound clean and following the instructions given by your.
Evo Terra: and if something, if we're feeling something's not right, if we have this wound, then it's, I guess my question, just when should someone seek out help if they think they might have a wound that is becoming hard to heal?
Dr Sherif Osmam: Well, like I said, most wounds. Very easily in the way that we would expect them to heal. If you see a wound that's getting larger, if there is significant inflammation surrounding the wound with redness and tenderness, increased discharge bad odor increased pain, that's the time when it's time to seek further.
Evo Terra: and if it is time for further care and something is done medically to help with this from all the things you mentioned I'm assuming this isn't always at least a one time treatment and you're good to go. This might even require several visits. Can you shine some light on that for us?
Dr Sherif Osmam: Sure. Most of the time when we see chronic non-healing wounds, we often have the patient come back every one to two weeks. To evaluate the efficacy of the treatments that we've prescribed and make sure that things are heading in the right direction. Oftentimes we have to make modifications in the treatment plan depending on how that wound progresses. And sometimes we even have to use things like compression bandages, for example, in patients who have a lot of edema in the lower extremities, which is major cause of non-healing wounds. And these oftentimes need to be changed on a weekly basis.
Evo Terra: Sounds like there's no one size fits all approach to any of this. There's a lot of underlying factors. And then as you said, what is the cause of this wound and why it wouldn't heal in the first place?
Dr Sherif Osmam: Exactly. Exactly. And there's just, it's so vast. And that's the thing that I enjoy so much about wound care is the complexity of it and the fact that there are so many different treatment modalities that are effective in caring for chronic wounds.
Evo Terra: Any other takeaways for our listen?
Dr Sherif Osmam: If you have a wound that fails to heal in a way that you would expect it to heal, ask your doctor for a referral to a wound center. The wound center specialize in healing complex non-healing wounds. This is what we do best. We do it day in, day out, and we see every kind of wound you can possibly
Evo Terra: dr. Thanks so much for sharing your time and knowledge with us today.
Dr Sherif Osmam: Thank. you.
Evo Terra: And once again, that was Dr. Sherif Osmam, the medical director at the University of Maryland Medical System. Find more shows just like this one at umms.org/podcast and on YouTube. Thank you for listening to Live Greater a Health and Wellness podcast, brought to you by the University of Maryland Medical System.
I'm Evo Terra and we look forward to you joining us again, and please share this on your social media.
Treatments for Hard to Heal Wounds
Evo Terra: Welcome to the Live Greater podcast series, information for a Healthier You from the University of Maryland Medical System. Im Evo Terra. At some point in time, you've probably had a wound, a cut finger that was fixed with a simple bandage or something that required stitches like a surgical procedure, and it probably healed fine, but that's not always the. To help understand how to treat hard to heal wounds.
Today I'll talk with Dr. Sherif Osmam, md. He's a medical director at the University of Maryland Medical System. Dr. Osmam, welcome to Live Greater.
Dr Sherif Osmam: Hi there.
Evo Terra: So, what makes a wound hard to heal and what, what qualifies as that word hard to heal?
Dr Sherif Osmam: we classify as wounds, as chronic wounds or problem wounds. These wounds are wounds that fail to heal as we would expect any wound to heal , when anyone be develops a wound. It goes through different stages of healing starting from the stage where the blood clots and the wound starts to seal all the way to when the wound becomes completely healed In scar tissue forms any of these when did disruptive, can result in a wound that fails to heal and becomes chronic.
Evo Terra: So what do we do with wounds? What do you do with wounds, I guess I should ask that won't heal? How are they typically treated
Dr Sherif Osmam: So oftentimes, these wounds that I see have already been seen by other physicians and have failed to heal. They've often been treated with antibiotics or surgery, and despite that, they've continued to be problematic. So the first thing that I do is try to determine the reasons for the wound not healing. The most common problem wounds occur after surgery where there's dehiscence, which means the wound fails to heal and reopens or after radiation or after burns or after wounds that develop in patients who are diabetic or patients with poor circulation. Autoimmune diseases often results in wounds that fail to heal. patients that are malnourished or have cancer chronic edema in the legs. I mean, swelling is a big problem for patients who have venous insufficiency in varicose veins. And sometimes I even see animal bites.
Evo Terra: Wow. Sounds like there's a lot of things that can cause this. One thing I know will never cause it though is having a mole removed from your back on your shoulder area and getting stitches in it, and then going out to play golf two days later that would never cause this problem. He said from experience ,
Dr Sherif Osmam: actually, I've seen this problem quite a number of times.
Evo Terra: I've seen it once and that was enough for me. I don't wanna do any more of that. Oh, well, let's talk about this for a second. I mean, there are lots of things where I want to get to, but clearly if we've got a wound that's not healing, people can't be with their doctor all the time. They have to somehow dress and treat this wound on their own. How often should we be changing dressings on a wound that cannot be healed?
Dr Sherif Osmam: Well, first of all, besides determining the cause of the wound, if there's any dead tissue that is on the wound, that's one of the first things that has to be removed the dead tissue a attracts bacteria and infection and causes inflammation, which. Results in poor. So we do things like surgical debridement, which means removing the dead tissue, . And then we use specific specialized topical antibacterial dressings. these dressings over the last 10 to 20 years have become very sophisticated and are impregnated with things like ionized silver and other antibacterial products. That kill bacteria without harming the growth that occurs on the wound. And these dressings can typically last anywhere between a couple of days, all the way up to seven days. And all that depends on the amount of fluid discharge from the wound. And so the more fluid, the more frequently the dressing needs to be changed.
Evo Terra: Right. . One thing that strikes me as we, we're talking about this, is I'm assuming that there might be people out there listening right now who are thinking, Hey, I've just had surgery. I've got this incision, or I just had this thing happen to me. It it, is there something we should be doing if we do have a wound so that we could do to maybe facilitate faster healing or something to prevent a wound from becoming hard to.
Dr Sherif Osmam: Well, most surgical wounds and acute wounds heal just fine. And oftentimes, the treatment that's prescribed by the surgeon who performs the procedure is more than adequate to heal. The overwhelming majority of wounds is these subtypes of wounds that result in poor healing. Like I said, require more attention. And the key is to determine what is the cause in a diabetic patient. It could be uncontrolled diabetes. Or it could be an an infection that requires antibiotics. The key is keeping the wound clean and following the instructions given by your.
Evo Terra: and if something, if we're feeling something's not right, if we have this wound, then it's, I guess my question, just when should someone seek out help if they think they might have a wound that is becoming hard to heal?
Dr Sherif Osmam: Well, like I said, most wounds. Very easily in the way that we would expect them to heal. If you see a wound that's getting larger, if there is significant inflammation surrounding the wound with redness and tenderness, increased discharge bad odor increased pain, that's the time when it's time to seek further.
Evo Terra: and if it is time for further care and something is done medically to help with this from all the things you mentioned I'm assuming this isn't always at least a one time treatment and you're good to go. This might even require several visits. Can you shine some light on that for us?
Dr Sherif Osmam: Sure. Most of the time when we see chronic non-healing wounds, we often have the patient come back every one to two weeks. To evaluate the efficacy of the treatments that we've prescribed and make sure that things are heading in the right direction. Oftentimes we have to make modifications in the treatment plan depending on how that wound progresses. And sometimes we even have to use things like compression bandages, for example, in patients who have a lot of edema in the lower extremities, which is major cause of non-healing wounds. And these oftentimes need to be changed on a weekly basis.
Evo Terra: Sounds like there's no one size fits all approach to any of this. There's a lot of underlying factors. And then as you said, what is the cause of this wound and why it wouldn't heal in the first place?
Dr Sherif Osmam: Exactly. Exactly. And there's just, it's so vast. And that's the thing that I enjoy so much about wound care is the complexity of it and the fact that there are so many different treatment modalities that are effective in caring for chronic wounds.
Evo Terra: Any other takeaways for our listen?
Dr Sherif Osmam: If you have a wound that fails to heal in a way that you would expect it to heal, ask your doctor for a referral to a wound center. The wound center specialize in healing complex non-healing wounds. This is what we do best. We do it day in, day out, and we see every kind of wound you can possibly
Evo Terra: dr. Thanks so much for sharing your time and knowledge with us today.
Dr Sherif Osmam: Thank. you.
Evo Terra: And once again, that was Dr. Sherif Osmam, the medical director at the University of Maryland Medical System. Find more shows just like this one at umms.org/podcast and on YouTube. Thank you for listening to Live Greater a Health and Wellness podcast, brought to you by the University of Maryland Medical System.
I'm Evo Terra and we look forward to you joining us again, and please share this on your social media.