Wounds Conditions We Treat

Cape Cod Healthcare takes a team approach to helping wounds heal. With physicians trained in wound care, certified wound care nurses and trained technicians, we work with you to assess your medical condition and identify the underlying cause of your non-healing wound, then develop a customized plan of care.

Wounds we treat include:

Arterial Ulcers - Ulcers that are formed anywhere on the legs or feet, due to arterial insufficiency, or limited blood being delivered to the lower extremities, often related to atherosclerosis. They typically occur on the toes, heels or bony prominences of the foot and the surrounding skin may exhibit reddish/purplish discoloration, may be cool to touch, or hairless, thin and brittle, with a shiny texture. These wounds are often painful, particularly at night when elevated, and may have a ‘stamped out' appearance. Patients often notice pain relief with the limbs in a dependent position. Patients may also have pain in their calves or back of their thighs when they walk, known as claudication. Arterial ulcers may require interventions to improve blood flow to the extremity to allow healing.

Diabetic Foot Ulcers - Any wound on a diabetic patient below the ankle is considered a diabetic foot ulcer. Diabetic neuropathy -- nerve degeneration which results in the lack of sensation in the lower extremities -- is the most common complication of diabetes and usually arises within five years of the onset of the disease. Foot ulceration develops due to increased pressures from tight-fitting shoes, and minor trauma that may go unnoticed. Neuropathy can lead to the development of foot deformities that increase the risk of ulcer formation. Ischemia (localized deficiency of arterial blood) and infection are often major culprits in chronic diabetic wounds. Diabetic foot ulcers are often preceded by the presence of a callous. Offloading of the Foot to minimize or eliminate the damaging pressure or trauma is often the cornerstone of treatment.

Traumatic – As we age, changes in the skin make us more prone to wounds related to minor trauma. Wounds can also occur as a result of major traumatic events, like a motor vehicle accident. Traumatic wounds include all types of abrasions, lacerations, skin tears, puncture wounds and burns.

Surgical Wounds – Wounds that occur as the result of a surgical procedure, including wounds that are left open at the time of surgery or incisions that open up after surgery. Separation of the opposed edges of a surgical wound can arise between the sixth and eighth postoperative day or after removal of stitches. The degree of separation may be partial or complete, resulting in exposure of underlying structures; frequently the consequence of age, obesity, diabetes, or infection.

Radiation injury - Even after beating cancer, some patients may experience delayed complications of the radiation they received. Radiated tissue is often hypoxic (low in oxygen) which can hinder normal function, put tissue at risk of breakdown and dramatically delay healing. The issues can arise sometimes many years after radiation treatment is completed.

Neuropathic ulcers – Wounds that occur as the result of diminished sensation or neuropathy. Neuropathy often occurs with diabetes but can occur for other reasons. Neuropathic ulcers typically occur on the foot. Injury may not be perceived due to a lack of sensation. Further tissue damage may go unnoticed leading to overt ulceration. Neuropathic ulcers may be deep and track to structures such as bone.

Venous Ulcer – Wounds on the lower extremity that occur as a result of venous insufficiency – inefficiency of the valves in the veins of the leg resulting in blood pooling in the lower extremities. Valves may become inefficient due to age or due to damage from previous blood clots. The increased pressures in the extremity result in ulceration. Venous stasis ulcers commonly occur in conjunction with the presence of varicose veins, brownish discoloration of the skin (hemosiderin staining), and chronic leg swelling. The mainstay of treatment for venous ulcers is Compression Therapy.

Lymphedema – Lower extremities can swell due to lymphatic system dysfunction. This can be a primary disorder or can occur as a result of surgery, trauma, or other underlying medical conditions. The increased swelling can result in blistering and ulceration. Wounds often leak copious amounts of watery drainage. Treatment is focused on controlling swelling in  a variety of ways, including: compressions therapy using compression garments or wraps; pneumatic pumps; or treatment by a lymphedema therapist who uses manual massage and/or extremity wrapping.

Pressure Injury – These are wounds that occur as a result of localized tissue damage caused by decreased blood flow associated with prolonged pressure. The typically occur over a bony prominence and are often associated with periods of immobility. Previously referred to as “bed sores,” they are not necessarily associated with being bedridden or being hospitalized. Certain pressure injuries can also be caused by the action of shear forces acting in concert with pressure on fragile skin. The amount of tissue damage beneath the skin is often more significant than can be appreciated from the outside. They are also commonly associated with some degree of malnutrition.

Wound Treatments We Provide:

Cape Cod Healthcare's Wound Care centers provide the latest in healing technology, expertise and treatments

Cellular Tissue Products

• Tissue Engineered Skin Substitutes advance wound healing by using living cells to promote healing
• Regenerative Tissue Matrix supports cell repopulation with stem cells by providing a framework for tissue regeneration
• Biological Membranes add growth factors and promote wound healing by stimulating cell migration to the ulcer site

Negative Pressure Wound Therapy (NPWT)

Often referred to as a “wound vac.” A sponge is placed in the wound which is connected to a vacuum pump via small tubing. The pump exerts negative pressure on the sponge which exerts negative pressure on the wound. NPWT supports wound healing by evacuating wound fluids, stimulating tissue growth, reducing the bacteria, maintaining a moist wound environment and ultimately reducing the time to heal. Multiple versions exist, including those with motorized pumps and those with small spring -loaded pumps (SNAP.)

Cellutome

TThis is a means to perform epidermal skin grafting in the clinic setting without the need for anesthesia. Many small blisters of skin are harvested via a special suction device. The harvested blisters are placed on the wound and act as “seeds” for new skin growth.