Wound Care/ Ulcer Care
Dr. Falknor is the medical director for the Memorial Hermann Southwest Wound Center located at Memorial Hermann Southwest in Houston, Texas. Treating wound patient for over 20 years. Successfully healing wounds with a team of other physicians such as infectious disease, vascular specialists, internist, radiologist, pathologist and many others.
What are wounds?
Also known as "sores or ulcers". Wounds are where the outer skin is missing and the deeper layers are exposed. Sometimes they are draining or have an odor. Many times wounds are red and infected. Sometimes they have been present for weeks, months or years. Sometimes wounds are painful, but not always.
What type of wounds do I treat?
Wounds develop from:
- Vascular disease (poor blood flow to the feet)
- Venous insufficiency (swelling of the leg/ ankle/ foot)
- Lack of sensation in the skin (peripheral neuropathy)
- Deformity of the foot or ankle
- Radiation burns
- Trauma or injury
- Bone infections (Osteomyelitis)
- Poor healing surgery
How do I treat wounds?
I always start with diagnosing the reason for the wound. It is important to know what caused the wound in order to resolve it quickly.
- Check for infection in the skin and bone. Sometimes antibiotics are needed (by mouth or intravenous)
- Check the blood flow to the leg/ ankle/ foot. Sometimes blood flow must be restored through surgery.
- Check the health status of the patient. Elevated blood sugars slow or prevent healing.
- If the patient is diabetic - they need to be counseled on appropriate nutrition for improved healing.
- Pressure needs to be taken off the wound.
Swelling must be controlled. Compression hose or other compression devices may be required to heal the wound or ulcer. Lymph pumps may be required when lymphedema is present.
Wounds have different phases and must be treated differently at each phase. Therefore, many different wound healing products are used.
Hyperbaric Oxygen Therapy (HBO) is used when appropriate. HBO is where you enter a clear chamber and that is pressurized. This increases the oxygen in the deeper layers of skin and improves healing.
Surgery is sometimes needed to complete healing. A large variety of surgery is utilized to resolve wounds and prevent new ones.
Diabetic shoes or braces are needed sometimes to prevent the wounds from returning after wound healing.
What is new in wound care?
Bone infections (osteomyelitis) is a serious problem when trying to resolve a wound. When the infection enters the bone, this is known as osteomyelitis. Osteomyelitis treatment will require IV
(intravenous) antibiotics for at least six weeks. Surgery is required when the IV antibiotics do not resolve the infection.
The surgeries for bone infection have traditionally required the removal of the infected bone. This often times results in the production of a new pressure point. This new pressure point may be the cause of a new wound or ulcer formation particularly when dealing with a foot ulcer.
I have been trying to change this outcome by changing my approach to bone infections or osteomyelitis.
I have been injecting the bone with antibiotics and have had some success in saving the infected bone. Therefore, no new ulcer site is produced. The procedure requires a small incision that often times does not require stitches. In many cases the patient can still walk on the surgical foot.
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