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Treating Foot Ulcers
How a Wound Care Center Can Help

by William J. Ennis, DO, MBA, and Patricio Meneses, PhD

No one wants to get a foot ulcer, but unfortunately, according to the American College of Foot and Ankle Surgeons, people with diabetes have a 15% chance of developing one at some point in their lives. Ulcers and other wounds are often the by-product of sensory neuropathy, a complication of diabetes that causes people to lose sensation on the bottoms of their feet. Without this protective sensation, the feet are vulnerable to repeated pressure or trauma that can cause injury. Peripheral vascular disease, in which blood vessels that serve outlying parts of the body narrow, is another potential complication of diabetes that can contribute to foot ulceration. By reducing the flow of blood to the feet, peripheral vascular disease decreases their supply of oxygen and nutrients, making it harder for wounds on the feet to heal.

Foot ulcers that are left untreated or are treated improperly can develop debilitating infections and put people at risk for lower-limb amputations. If you develop a foot ulcer, getting prompt and aggressive treatment is the best way to help the ulcer heal and avoid further complications. For this reason, a specialized wound care center may be a good option for treatment. Multiple scientific studies have shown that people with diabetic foot ulcers achieve better outcomes when treated by a multidisciplinary team of health-care providers. A wound care center not only concentrates a variety of specialists in one place, but it can also provide a range of advanced wound care therapies, one or more of which may be the right choice for treating your wound.

Since the mid-1980’s, wound care centers have been developing throughout the United States. Initially, each of these programs focused on a specific type of therapy and did not truly provide comprehensive care. Over time, however, and with the growing number of wound care products and technologies now available, multidisciplinary wound care centers have become common on the health-care landscape. Most wound care centers achieve a high success rate through collaborative work among various team members. Centers also develop expertise simply by seeing a large volume of patients with similar problems. Overall healing rates of around 80% should be achievable within 16 weeks of therapy at a specialized wound care center.

If you are referred to a wound care center for treatment of a foot ulcer or other condition, it would serve you well to educate yourself about the staff, treatments, and educational options available at the center. This article explains how wound care centers work and some of the innovative treatments they can provide for diabetic foot ulcers.

What to expect at a wound care center
Most wound care centers are located within or immediately adjacent to an acute care hospital. The center may be run by the hospital, or the hospital may choose to subcontract with a management company that runs wound care centers across the country. A panel of physicians works at the center, with each physician traditionally covering a half-day clinic. The physicians’ primary areas of training can be varied. Primary care, surgery, orthopedic, podiatric, and internal medicine physicians are but a few of the possible specialists found in a wound care center. All of them, however, should have additional training specific to wound care. This training may come from attending seminars and workshops or, in the case of corporate-run wound care centers, participating in formal wound care education programs. There is also currently a process by which health-care providers can take an examination sponsored by the American Academy of Wound Management. Successful completion of the examination results in the clinician obtaining the C.W.S. (Certified Wound Specialist) designation. There is, however, no formal board certifying process at this time for physicians in the field.

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Statements and opinions expressed on this Web site are those of the authors and not necessarily those of the publishers or advertisers. The information provided on this Web site should not be construed as medical instruction. Consult appropriate health-care professionals before taking action based on this information.



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