Article: Modern Wound Technology
Modern wound technology: There's hope for healing as new center opens in Stoughton
By SUE SCHEIBLE
The Patriot Ledger
As a young woman, Elsie Smith took her smooth skin for granted. Her clear, rosy complexion won her lots of compliments and as she grew older, she was fortunate, she says, ‘‘not to age too quickly.''
‘‘I really didn't get my wrinkles until I was in my early 70s,'' she said. ‘‘A photo from my 50th anniversary shows I didn't have wrinkle one yet.''
That was just a few years ago. But last fall, after Smith's leg swelled up from cellulitis, a potentially dangerous soft tissue infection, she developed a blister that turned into a five-month ordeal.
She believes she might still be living that nightmare if not for the new Wound Care Center at New England Sinai Hospital in Stoughton. The center opened Nov. 12.
‘‘It wasn't until I got to the center that my wound started healing,'' Smith said last week from her home in Bridgewater, where she has just ended months of intravenous treatments.
Smith, 77, never realized that wounds of no consequence in young people can turn into serious, even limb-threatening infections in older people. At one point, she said, there was even concern she might lose part of her leg.
Wound treatment has changed dramatically in recent years, with greater understanding of how healing is related to many different factors, including nutrition.
The wound care market has exploded with more than 3,000 products to choose from, according to Vivian Sternweiler, a clinical nurse specialist at New England Sinai's Wound Treatment Center.
‘‘I love the challenge of putting the pieces of the puzzle together to help the patients heal,'' said Sternweiler, of Sharon. ‘‘Thankfully, we have been having really good results, because some people have been dealing with these wounds for months and in some cases for years, and they really need some help.''
When Smith's leg first swelled up, she formed a blister on her calf that grew to three inches long, one inch wide and one inch deep. She believes now that her socks kept rubbing the blister and it became infected. The infection got into her muscles and she spent seven weeks in the hospital and then a rehabilitation center before she went home, where a visiting nurse came daily to change the dressing. Still, the open, raw wound wouldn't close. Her doctor sent her to Sinai's new center.
There, Dr. Sherry Skovell, the center's medical director and director of endovascular surgery at Beth Israel/Deaconess Medical Center, and Sternweiler bound Smith's leg in pressure bandages so the swelling wouldn't keep re-opening the wound. They kept the wound clean and gave Smith a more powerful antibiotic.
Skovell had first checked the circulation in Smith's leg to make sure she had enough blood flow to heal the wound. Satisfied that her circulation was good, they turned to the compression bandage therapy to decrease the swelling and used a new type of dressing.
‘‘We used a moist dressing approach,'' Sternweiler said. Some wounds heal faster in a moist environment, rather than drying out the area around the wound which was once thought of as the only way to do it. They also made sure Smith was taking all the best vitamins and minerals and eating enough protein. ‘‘Protein is important for the new cells to grow in,'' Sternweiler said.
Smith's wound is now an inch or less in size. She still has to stay in her apartment, is using a walker and cannot drive, but she looks forward to getting her life back.
Wound treatment has become a medical specialty for physicians, nurses and even physical therapists.
At one time, drying out a wound was considered the best treatment, according to Sternweiler. ‘‘If a wound is still draining, then you have to find the right absorbent dressing to wick the moisture away so that the surrounding skin isn't affected,'' she said. New research shows that some wounds heal faster, with less pain, and with less scarring if they are kept in a moist environment.
The New England Sinai wound center treats a variety of problems, including leg and foot ulcers, diabetic ulcers, pressure ulcers or bed sores, open surgical wounds and traumatic wounds. The ages of the patients vary but most are adults, with many middle-aged or older.
In people as young as their 30s or 40s, sometimes surgical wounds don't heal well, or falls and chronic illnesses such as diabetes can lead to stubborn infections.
The special treatment involves the new range of dressings and debriding or cutting away dead tissue to allow the new tissue to grow in. Antibiotic therapy and nutrition can be just as important.
Another recent success story is 87-year-old Lillian Pink, who fell in her Easton home a year ago and had a deep wound on her left leg that wouldn't heal. Her whole lower leg became involved and after doctors tried everything they could think of, they referred her to the wound center.
At the clinic, the medical staff took new cultures from Pink's infected leg and were able to treat two specific bacterial infections with intravenous therapy. The improvement has been dramatic, said Pink's daughter, Linda Masters of South Easton.
‘‘When my mother had the infection, I saw her whole energy level drained out of her and her health depleted,'' Masters said.
The wound center staff also includes Barry Rosenblum, a podiatrist who is board certified in podiatric surgery and heads the foot center at the hospital.
For more info
The wound center has appointments on Friday mornings and expects to soon expand. For information, call 781-297-1500 Monday through Friday between 9 a.m. and 5 p.m. The staff will assist with any needed insurance approvals.
Sue Scheible may be reached at sscheible@ledger.com.
Copyright 2005 The Patriot Ledger
Transmitted Tuesday, February 22, 2005