By Elizabeth Marie Himchak
Palomar Health’s two wound care centers, including one in Poway, are gaining attention for their success in treating difficult injuries, hospital officials said.
Pamela Montanile, community education specialist for the wound care centers, said patients are not only coming through Palomar Health and its associates like Arch Health Partners, but by recommendations from doctors at UCSD, Scripps and Sharp throughout San Diego County and from health organizations in neighboring counties as well.
“Our 93 percent healing rate is phenomenal,” she said, adding because Palomar Health’s two centers have a team of various specialists, there is better communication and patients do not have to “ping-pong between different specialists” when their treatment plan is being created.
“Why did the wound happen and why won’t it heal? ... (These) often need a group effort (to figure out),” she said. “(Here) patients get a very comprehensive first visit.”
Over 90 minutes, she said, sophisticated testing is done to determine whether the treatment will be performed by a doctor who specializes in infectious diseases, is a vascular surgeon or a plastic surgeon, for example.
Patients’ hard-to-heal wounds are caused by various illnesses, injuries and treatments, she said.
One leading cause for non-traumatic lower-limb amputations among adults is wounds associated with diabetes, which account for more than 60 percent of the cases, according to the American Diabetes Association.
“Diabetic patients face multiple challenges in the healing process,” said Dr. Roger Schechter, the center’s medical director. “Their circulation is diminished and they have an impaired ability to sense the earliest stages of foot injury due to disease-related nerve damage.”
Montanile said diabetes-related injuries account for 25 to 30 percent of the wounds treated at the center, explaining that because the feet and lower legs are farther from the heart than other areas of the body, the blood supply and the oxygen needed to keep them healthy does not flow as easily as it should.
This can lead to a loss of feeling in feet, for example, and when injured — such as stepping on a pin — the person is unaware that the injury has even occurred. Other times a “foot ulcer” can form, similar to but more severe than a blister, if there is a foot deformity that rubs on the inside of a shoe.
Other wounds are associated with peripheral artery disease and illnesses which can cause a vein or artery to start leaking and/or coming up through the skin’s surface, she said.
Various methods are used to treat these injuries, one of which is hyperbaric oxygen chambers. Palomar Health has two for individual use at each of the clinics in Poway and San Marcos.
Undergoing hyperbaric treatment is a serious endeavor that requires a commitment of at least two hours a day, five days a week for four to eight weeks in most cases, Montanile said, adding the average heal rate is 29 days.
Through hyperbaric therapy, oxygen at 100 percent concentration is given to patients at two-and-a-half times the normal pressure — similar to that experienced when below sea level at such a depth. The normal amount of oxygen people breathe in is at a 20 percent concentration, she said.
Once the pressurized oxygen enters the body, it transforms into liquid form and then traverses throughout the body and into the tissues where the injury exists. This builds capillaries in the damaged tissue, which leads to regenerating a blood supply there and promotes healing, she explained.
“It is certainly a lifesaver,” Montanile said.
While treatments are available to cure wounds, Montanile said medical officials try to prevent such wounds from occurring in the first place, especially those associated with diabetes.
The wound center staff recommends diabetic adults — especially those middle age and older — inspect their feet daily for injury and immediately seek treatment if a lower extremity wound is increasingly painful, becomes red, swells, has a foul odor, changes color or has a change in drainage amount.
Other symptoms to watch out for include pain or cramping in the legs, buttocks, thighs or calves; tingling, burning or painful feet; loss of touch or ability to feel hot or cold; changes in shape, color or temperature of feet; hair loss on toes, feet and lower legs; dry or cracked skin on feet; thick and yellow toenails or fungus infections between the toes; and blisters, sores, infected corns and ingrown toenails.
For information on Palomar Health’s diabetes services and education programs, call 760-510-7377.
For Palomar Health’s wound care center, call
858-613-6255. The Poway center is on the second floor of the Pomerado Outpatient Pavilion, 15611 Pomerado Road.