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Services

hyperbaric wound care doctorThe CHRISTUS St. Vincent Wound and Hyperbaric Center is dedicated to the provision of state-of-the-art, outpatient clinical wound care and hyperbaric medicine. We want physicians to think of our Center as an extension of their practice. Referring physicians maintain the care of their patient's underlying disease and continue to provide for the patient's overall care. The Center only treats the wound.


Patients Remain in Your Care

When you refer a patient, the patient meets with our staff for a consultation, including an examination and medical history evaluation. Information regarding the patient's progress, along with updated photos of the wound, will be submitted to you at your request. You are always welcome to call the Center for an update. The patient remains under your care.


Our Specialization - Advancing Wound Care

The coordinated use of a variety of clinical treatments, debridement, medicines, dressings, and support services to treat chronic wounds has proven highly effective in facilitating the healing process.


When to Utilize the Center and Which Patients Benefit Most

Any patient with a wound that has not started to heal in about two weeks or has not completely healed in six weeks is a potential candidate.

The Center's staff specializes in the treatment of chronic, non-healing wounds. Some of the indications for wound therapy are:

  • Pressure ulcers
  • Surgical wounds
  • Diabetic ulcers
  • Vasculitis
  • Neuropathic ulcers
  • Burns
  • Ischemic ulcers
  • Peristomal skin irritations
  • Venous insufficiency
  • Traumatic wounds
  • Other chronic, non-healing wounds

Individualized Treatment Plans

The Center utilizes the newest clinical tools in wound healing along with traditional clinical practices including:

  • Wound dressings
  • Prescriptive growth factors
  • Debridement
  • Bio-engineered skin grafting
  • Compression therapy
  • Edema management
  • Hyperbaric oxygen therapy
  • Non-invasive vascular assessment

Patient care at the Center focuses on a whole body approach to wound healing, including:

  • Nutritional assessment and counseling
  • Pain management
  • Diabetic education
  • Special needs for pressure relief including beds, seat cushions and footwear
  • Patient and caregiver counseling

Hyperbaric Oxygen Therapy

hyperbaric wound care equipment Hyperbaric oxygen therapy is an adjunctive therapy in which the patient breathes 100 percent oxygen while enclosed in a pressurized chamber at greater-than-normal atmospheric pressure.

While breathing pure oxygen, the patient's blood plasma becomes saturated, carrying 15 to 20 times the normal amount of oxygen to the body's tissues. The ultimate result is that the body's natural wound-healing mechanisms, which are oxygen dependent, are able to function more efficiently. About 18 percent of wound care patients may require hyperbaric oxygen therapy.

Hyperbaric oxygen therapy is an important adjunct in the treatment of non-healing wounds.
An established technology, Hyperbaric oxygen therapy has been shown to help in treating:

  • Select problem wounds
  • Crush injuries
  • Acute traumatic ischemia
  • Necrotizing soft tissue infections
  • Refractory osteomyelitis
  • Radiation tissue damage
  • Compromised skin grafts, flaps and replants
  • Diabetic ulcer of the lower extremity
  • Gas gangrene
  • Non emergency carbon monoxide poisoning

Hyperbaric oxygen therapy involves the systemic delivery of oxygen to patients placed in a chamber at two to three times atmospheric pressure while breathing 100 percent oxygen between 90 and 120 minutes.

The effects of increased oxygen tension include:

  • Vasoconstriction and the reduction of edema in the area of trauma for crush injuries. Tissue oxygen levels may be 10 to 20 times that achieved by normobaric oxygen breathing.
  • Increase in oxygen diffusion distance from functioning capillaries in the hypoperfused wounds. Oxygen is necessary for the functioning of fibroblasts, osteoclasts and granulocytes in wound healing.
  • Stimulation of neovascularization in ischemic tissues
  • Support of leukocyte oxidative bacteria kills as an adjunct to antibiotics and wound care

Reimbursement for hyperbaric oxygen therapy :

  • Hyperbaric oxygen therapy is reimbursable by Medicare and most other third party payors for certain clinical applications. Reimbursement, however, varies and pre- authorization for this service may be required by the patient's health care plan. The Center will work with you to ascertain coverage.

Approved Indications for Hyperbaric Oxygen Therapy

The following is a list of approved indications currently reimbursed by Medicare, HMOs and other insurance carriers:

  • Soft tissue radionecrosis
  • Crush injury/acute traumatic peripheral ischemia
  • Actinomycosis
  • Progressive necrotizing infections (necrotizing fascitis)
  • Preservation of compromised skin grafts and flaps
  • Acute peripheral arterial insufficiency
  • Chronic refractory osteomyelitis
  • Osteoradionecrosis
  • Diabetic ulcer of the lower extremities

Other approved indications (emergent) are only treated in hyperbaric facilities staffed and equipped to provide emergency services on a 24-hour basis. This Center at present is not equipped to handle emergency situations.


Clinical Indication

hyperbaric wound care treatmentHyperbaric oxygen therapy may be used as either primary or adjunctive care in:

Select Problem Wounds:
In a hypoxic environment, wound healing is halted by a decrease in fibroblast proliferation, collagen production and capillary angiogenesis. Hyperbaric oxygen therapy can restore a favorable tissue environment in which healing and antibacterial mechanism can occur.

Skin Grafts, Flaps and Replants:
Following ischemia or vascular repair in cases where there has been decreased microcirculation, hyperbaric oxygen therapy has been demonstrated to maximize the viability and final functional level of the compromised nerve and muscle tissue.

Crush Injuries, Compartment Syndrome, and Other Acute Traumatic Ischemias*:
Hyperbaric oxygen therapy increases tissue oxygen tension to levels which allow host responses to infections and ischemia to become functional. Effects include enhanced oxygenation at the tissue level, increased oxygen delivery per unit of blood flow and edema reduction.

Radiation Tissue Damage:
Hyperbaric oxygen therapy is the gold standard of care in reconstructive surgery involving irradiated bone or soft tissue. In proper coordination with surgical treatment, it has reoriented the approach to the repair of radiation damaged tissue. It has been shown to stimulate growth of functioning capillaries, fibroblastic proliferation and collagen synthesis in the irradiated bone and soft tissue. Improved healing rates and reduced complication rates are seen in a coordinated reconstructive program using adjunctive hyperbaric oxygen therapy.

Chronic Refractory Osteomyelitis: Hyperbaric Oxygen Therapy
stimulates osteoclast formation and improves leukocyte function in infected bone tissue. It is used as an adjunct to antibiotics, debridement, nutritional support and reconstructive surgery. In cases of superficial, localized (e.g. sterna wounds) and diffuse osteomyelitis, particularly in the presence of localized or systemic host compromise, hyperbaric oxygen therapy has proven adjunctive therapeutic value. In these most difficult to resolve infections, hyperbaric oxygen therapycan often save life or limb.

Necrotizing Soft Tissue Infections:
As an adjunct to debridement and systemic antibiotics, hyperbaric oxygen therapy adversely affects anaerobic bacterial growth and enhances leukocyte bacterial killing. Certain toxins (e.g. clostridial) may be inactivated by high oxygen tension. Published studies indicated adjunctive hyperbaric oxygen therapy use can decrease mortality by two-thirds.

* Requires immediate consultation for optimal results. For best results, suspicious hypoxic wound complications should be addressed as early as possible. In particular, potential skin grafts, flap failures or crush injuries should be treated within the first four hours of the onset of pathology.

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