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Helping Nature Heal Persistent Wounds

The Wound Healing Center at Sentara RMH

All of us have experienced wounds, whether a small paper cut or a larger, more serious break in the skin—so the healing process is likely a familiar one. When bleeding is involved, blood clots quickly develop to help stop the flow, eventually forming a scab that protects the damaged underlying tissue. As the scab forms, and for days afterward, the immune system kicks in to protect the body from invading germs. The injured area usually becomes swollen and slightly red, and may feel warm, as blood supplies the wounded area with white blood cells to fight off infection and provide nutrients and oxygen to heal the wound. Over the coming days and weeks, the wound fills in with new tissue and, in the case of deeper injuries, forms a scar that may or may not disappear completely in time. While larger wounds take longer to heal, they usually are well on the way to healing within two to four weeks.

That’s how the healing process is supposed to work, but various factors can slow it down or even stop it entirely. Persistent or chronic wounds—those that have not healed by at least 40 percent within four weeks—often require special medical care to help them heal, and that’s the kind of expertise provided by the Wound Healing Center at Sentara RMH. The center has a staff of specially trained doctors, nurses and technicians equipped with a wide variety of treatment options to address a broad range of wound-related challenges.

Oxygen as a Healer

Harrisonburg resident James Tingle is well acquainted with the frustration of dealing with a nonhealing wound. In 2015, Tingle was diagnosed with prostate cancer and had his prostate removed. Not all of the cancer could be removed surgically, however, so he underwent radiation treatment. During that process, Tingle developed radiation cystitis, which resulted in extensive pain and urinary bleeding.

“Although radiation is a useful and effective therapy for cancer, it can also cause healthy soft tissue to die,” says Peter Buckman, MD, medical director of the Wound Healing Center. “Using hyperbaric oxygen therapy (HBOT) to treat these wounds, it’s possible to see as much as a 90 percent reduction in pain and bleeding. In fact, radiation injuries are some of the best indications for the use of HBOT.”

HBOT involves having the patient breathe pure oxygen in a specialized chamber, where the air pressure is three times higher than normal. As the patient breathes in this environment, the lungs absorb more oxygen than they could at normal air pressure. This super concentration of oxygen spreads throughout the body, where it helps fight bacteria and stimulate wound closure, tissue regeneration and new tissue growth.

“Somewhere around the third or fourth week of HBOT, absolutely all of the bleeding had stopped,” recalls Tingle, who is retired. “The pain also had started to subside significantly.”

Tingle notes that HBOT also resulted in other side benefits. As his treatments continued, he noticed that he was able to go longer periods of time without having to go to the bathroom.

“Before the HBOT treatments, I was going to the bathroom eight or nine times a day,” he says. “By the last couple of treatments, I was going much less frequently.”

Tingle’s daily, two-hour treatments continued for 10 weeks.

“I just can’t say enough about how nice the staff and administrators at the Wound Healing Center were,” says Tingle. “Dr. Buckman always made a point of checking up on me whenever he was working during my treatments, and everyone went out of their way to make me feel safe and comfortable.”

Healing with Bioengineered Skin

Donald Moyers’ experience with the Sentara Wound Healing Center has also been positive. In September 2018, the 84-year-old Harrisonburg resident was at Sentara RMH for an issue related to blood pressure. According to Moyers, he was being released from the hospital when a hematoma, a collection of blood outside a vessel that forms due to disease or trauma, appeared on his right lower leg.

“That’s also about the time that the thing popped,” Moyers says. “It bled so much that if I had been at home instead of at the hospital, it could have been a dangerous situation.”

To address the problem, Moyers was admitted to Sentara RMH, where initially he was treated with negative-pressure wound therapy, which involves the use of a vacuum dressing that enhances and promotes wound healing in acute, chronic and burn wounds.

The next day he was released to the Virginia Mennonite Retirement Community, where the nursing staff was instructed on how to treat and dress his wound. However, four weeks of standard care failed to provide adequate healing. That’s when Moyers sought help from caregivers at the Wound Healing Center.

“After about 12 weeks of treatment at the center, Mr. Moyers’ wound healing began to stall,” recalls Alisha Botkin, RN, clinical nurse manager of the Wound Healing Center. “We jump-started the healing process with an antimicrobial-embedded dressing, and then took his wound to closure with a cellular-based tissue product bioengineered with living keratinocytes and fibroblast cells—both of which are found in the layers of human skin and help to stimulate growth of healthy new tissue.”

Extremely thin layers of the artificial skin were applied to his wound every week. Within about 10 weeks, according to Moyers, his wound had healed.

Moyers says he is grateful for the level of care he received at the Sentara Wound Healing Center.

“I don’t know where else I could have gotten that level of treatment,” he adds. “The doctors and nurses were all very skilled, and everyone I met was courteous and treated me well. What more could you ask for?”

Do You Need Specialized Wound Care?

A physician referral is not required to make an appointment at the Sentara Wound Healing Center—you can self-refer, if you choose. Call us at 540-689-2100, or ask your doctor about visiting the center if:

•  You have a wound that hasn’t healed within 30 days (commonly experienced by people with diabetes)

•  You have a sore with increased redness, swelling, pain, foul odor or a change in color

•  You have a surgical wound that has become infected

The Sentara Wound Healing Center is located at Sentara RMH Medical Center (in the main hospital, just inside the outpatient entrance) at 2010 Health Campus Drive, Harrisonburg.

The Types of Wounds We Treat

The Sentara RMH Wound Healing Center treats a variety of wounds:

• Foot and leg ulcers and wounds (diabetic foot ulcers)

• Arterial and venous ulcers

• Connective-tissue disorders

• Internal injuries or open wounds from radiation therapy

• Nonhealing surgical wounds

• Nonhealing skin grafts or surgical flaps

• Acute traumatic wounds

• Any chronic wound that has not healed or is not anticipated to heal by at least 40 percent within four weeks

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