Wound Care at Penn Highlands Healthcare

Every year, chronic wounds affect 6.7 million people in the U.S. The incidence is rising as our population ages and there are increasing rates of chronic health conditions such as diabetes, peripheral vascular disease and cancer to mention a few.

A chronic or non-healing wound is one that hasn't begun to heal in two weeks or hasn't completely healed in six weeks. If left untreated, chronic wounds can lead to diminished quality of life, health complications and possibly amputation of the affected limb.

The treatment of non-healing wounds has become a specialty unto itself. The time involved to help these wounds heal could be prohibitive in many physician offices. One must seek medical attention at a place that primarily focuses on wound care.

At Penn Highlands Healthcare, there are three locations that specialize in wound care:

• The Penn Highlands Clearfield Wound Clinic is located on the first floor of PH Clearfield, 809 Turnpike Ave., Clearfield. Hours of operation are Monday, Wednesday and Friday from 8 a.m. to 4:30 p.m.

• The Wound Center of Penn Highlands DuBois is located on the ground floor at PH DuBois East, 635 Maple Avenue, DuBois. Hours of operation are 7 a.m. to 3:30 p.m. Monday thru Friday.

• The Penn Highlands Elk Wound Clinic is located at PH Elk, 763 Johnsonburg Road, St. Marys. Hours of operation are 8 a.m. to 3 p.m. Monday and Tuesday and 1-7 p.m. Wednesday.

Done in an outpatient setting, treatment is given to non-healing wounds and quality of life is improved for many. “No wound has to be chronic,” Kim Sleigh, MSN, director of Practice Management, said.

Who goes to a wound center? People that have ulcers, burns, non-healing surgical wounds, wounds from a trauma or pressure ulcers that conventional methods haven’t worked for, Wanda Rougeux of the PH Clearfield Wound Clinic, said. Also, it’s for people with diabetic wounds, lymphedema, abscesses, certain cysts or non-healing wounds of any type, Kathy Wortman, RN, BSN, of the PH Elk Wound Clinic, added.

“We get many referrals from family practice doctor's that have exhausted the usual treatments and need further expertise. We also see many of our skilled nursing facilities patients for treatment when wounds have become uncontrollable. We take pride in healing difficult wounds with our advanced therapies. We also get referrals from our Emergency Department for wounds,” Rougeux said.

“Causes are many and varied,” Wortman said. “Diabetes can inhibit healing of any kind. Poor circulation can also make healing difficult.” Sometimes patients have issues with a treatment plan and can’t follow it, or they can injure an already wounded area.

“We offer comprehensive skin and wound care, with specialized wound care and knowledge of product and therapies,” she said.

The first step in healing a wound is performing a thorough wound assessment and reviewing the patient’s health history in order to identify factors that may contribute to poor wound healing, according to Sleigh. Then a patient specific plan will be created and implemented.

One of the next steps is usually debridement, the process of removing dead skin and tissue. This tissue is removed to help your wound heal. There are many ways to do this. It can be done surgically, by washing it or with enzymes that dissolve dead tissue. Sometimes, it may take a process of applying wet-to-dry dressings to the area. When the wet dressing dries and is removed, it takes dead cells with it.
After cleaning, your wound care team will measure the depth of the wound. It may seem bigger and deeper after debridement, but it will actually be the true size. Then, an appropriate dressing for your type of wound will be applied.

There are also possible treatments, including:
• Compression stockings - tight-fitting stockings or wraps that improve blood flow and help with healing;
• Ultrasound - using sound waves to aid healing;
• Skin substitute – tissue derived from human skin;
• Negative pressure therapy - creates a vacuum to improve blood flow, increase tissue growth and pull out excess fluid;
• Growth factor therapy - materials produced by the body that helps wound-healing cells grow.

“Depending on the type of wound, hyperbaric oxygen therapy may be recommended. Oxygen is important for healing,” Sleigh said. “During this treatment, you lie inside a special chamber filled with 100 percent oxygen. The pressure inside the chamber is approximately two and a half times greater than the normal pressure in the atmosphere. This pressure helps your blood carry more oxygen to organs and tissues in your body. Hyperbaric oxygen therapy can help some wounds heal faster.” This therapy is available at PH DuBois.

“All of these decisions are made by a special team of healthcare providers,” Sleigh said. “We are comprised of a unique staff of qualified wound specialists,” Rougeux added.

“At PH Clearfield, we have a general surgeon that is our director, Dr. Robert Steward, and we have three podiatrists: Dr. Courtney Johnson, Dr. Thomas Hoffman and Dr. Tammy Carlson-Little,” Rougeux said. They are supported by three registered nurses and one LPN and clinic coordinator that work hands-on with patients.

“At PH DuBois, Dr. Shalva Kakabadze, family medicine physician and Dr. Bradley J. Magill, podiatrist, work alongside medical assistants and registered nurses.

At PH Elk, the clinic is staffed by Dr. Narayana Subramany, general and vascular surgeon, and Dr. John Hewitt, podiatrist and two registered nurses.

For more information about wound care, call the clinics and center at 371-4320 at PH DuBois, 768-2050 at PH Clearfield or 788-8300 at PH Elk.