Questions & Answers
1What is a Wound Care Center?
While there are many examples of wound care centers, HHI has an approach that effectively partners with the host hospital to provide a comprehensive provider based clinic that specializes in outpatient care for patients with chronic non-healing wounds.
We call these Wound Healing and Hyperbaric Medicine Centers that effectively function as outpatient centers as well as departments of the hospital. They include specialty trained Physicians, Mid-Level Providers (ie Nurse Practitioners and Physician Assistants) Nurses, Technologists, and Administrative/Clerical staff.
We call these Wound Healing and Hyperbaric Medicine Centers that effectively function as outpatient centers as well as departments of the hospital. They include specialty trained Physicians, Mid-Level Providers (ie Nurse Practitioners and Physician Assistants) Nurses, Technologists, and Administrative/Clerical staff.
1Who Needs Wound Care?
Sometimes, despite time and personal attention, a wound develops that is too big, too deep, too difficult to heal without professional help.
There are a variety of circumstances in which a person may need wound care. They include, but are not limited to:
• Ulcers (pressure, diabetic, neuropathic or ischemic)
• Surgical wounds
• Vasculitis
• Burns
• Peristomal skin irritations
• Soft tissue radionecrosis
• Actinomycosis
• Preservation of compromised skin grafts and flaps
• Crush injury/acute traumatic peripheral ischemia
• Progressive necrotizing infections (necrotizing fasciitis)
• Osteoradionecrosis
• Traumatic wounds
A Multidisciplinary Team Approach for Treatment of Non-Healing Wounds where a variety of treatment options are available depending on type and severity of a wound.
Treatment may include the following:
• Infectious disease management
• Physical therapy
• Vascular evaluation
• Laboratory evaluation
• Nutritional management
• Pain management
• Diabetic education
• Nuclear medicine
• Radiology
• Debridement
• Hyperbaric oxygen therapy
There are a variety of circumstances in which a person may need wound care. They include, but are not limited to:
• Ulcers (pressure, diabetic, neuropathic or ischemic)
• Surgical wounds
• Vasculitis
• Burns
• Peristomal skin irritations
• Soft tissue radionecrosis
• Actinomycosis
• Preservation of compromised skin grafts and flaps
• Crush injury/acute traumatic peripheral ischemia
• Progressive necrotizing infections (necrotizing fasciitis)
• Osteoradionecrosis
• Traumatic wounds
A Multidisciplinary Team Approach for Treatment of Non-Healing Wounds where a variety of treatment options are available depending on type and severity of a wound.
Treatment may include the following:
• Infectious disease management
• Physical therapy
• Vascular evaluation
• Laboratory evaluation
• Nutritional management
• Pain management
• Diabetic education
• Nuclear medicine
• Radiology
• Debridement
• Hyperbaric oxygen therapy
1What is Hyperbaric Oxygen Therapy (HBOT)?
The Undersea and Hyperbaric Medical Society (UHMS) defines hyperbaric oxygen (HBO2) as an intervention in which an individual breathes near 100% oxygen intermittently while inside a hyperbaric chamber that is pressurized to greater than sea level pressure (1 atmosphere absolute, or ATA). For clinical purposes, the pressure must equal or exceed 1.4 ATA while breathing near 100% oxygen.
The United States Pharmacopoeia (USP) and Compressed Gas Association (CGA) Grade A specify medical grade oxygen to be not less than 99.0% by volume, and the National Fire Protection Association specifies USP medical grade oxygen.
In certain circumstances hyperbaric oxygen therapy represents the primary treatment modality while in others it is an adjunct to surgical or pharmacologic interventions. Treatment can be carried out in either a mono or multiplace chamber. The former accommodates a single patient; the entire chamber is pressurized with near 100% oxygen, and the patient breathes the ambient chamber oxygen directly. The latter holds two or more people (patients, observers, and/or support personnel); the chamber is pressurized with compressed air while the patients breathe near 100% oxygen via masks, head hoods, or endotracheal tubes.
According to the UHMS definition and the determination of The Centers for Medicare and Medicaid Services (CMS) and other third party carriers, breathing medical grade 100% oxygen at 1 atmosphere of pressure or exposing isolated parts of the body to 100% oxygen does not constitute HBO2 therapy. The patient must receive the oxygen by inhalation within a pressurized chamber. Current information indicates that pressurization should be to 1.4 ATA or higher.
The United States Pharmacopoeia (USP) and Compressed Gas Association (CGA) Grade A specify medical grade oxygen to be not less than 99.0% by volume, and the National Fire Protection Association specifies USP medical grade oxygen.
In certain circumstances hyperbaric oxygen therapy represents the primary treatment modality while in others it is an adjunct to surgical or pharmacologic interventions. Treatment can be carried out in either a mono or multiplace chamber. The former accommodates a single patient; the entire chamber is pressurized with near 100% oxygen, and the patient breathes the ambient chamber oxygen directly. The latter holds two or more people (patients, observers, and/or support personnel); the chamber is pressurized with compressed air while the patients breathe near 100% oxygen via masks, head hoods, or endotracheal tubes.
According to the UHMS definition and the determination of The Centers for Medicare and Medicaid Services (CMS) and other third party carriers, breathing medical grade 100% oxygen at 1 atmosphere of pressure or exposing isolated parts of the body to 100% oxygen does not constitute HBO2 therapy. The patient must receive the oxygen by inhalation within a pressurized chamber. Current information indicates that pressurization should be to 1.4 ATA or higher.
1What are the medical indications for HBOT?
Indications
1. Air or Gas Embolism
2. Carbon Monoxide Poisoning
3. Clostridial Myositis and Myonecrosis (Gas Gangrene)
4. Crush Injury, Compartment Syndrome and Other Acute Traumatic Ischemias
5. Decompression Sickness
6. Arterial Insufficiencies
7. Severe Anemia
8. Intracranial Abscess
9. Necrotizing Soft Tissue Infections
10. Osteomyelitis (Refractory)
11. Delayed Radiation Injury (Soft Tissue and Bony Necrosis)
12. Compromised Grafts and Flaps
13. Acute Thermal Burn Injury
14. Idiopathic Sudden Sensorineural Hearing Loss
1How does HBO work?
Hyperbaric Oxygen Therapy (HBOT): HBOT works in wound healing by increasing the concentration of oxygen in the plasma and soft tissue to oxygenate hypoxic wounds. It also increases the distance that oxygen molecules can diffuse from the vessels into the tissues.
1How does HBO benefit the patient?
Research has demonstrated that it causes vasoconstriction (reduction of edema), while increasing collagen synthesis, forming new blood vessels, and enhancing leukocyte function (fighting infection).
Physiologic mechanisms:
• Antibacterial
• Bacterial exotoxin production
• Enhances leukocyte (white blood cell) function
• Enhances production of growth factors and receptors (PDGF, VEGF, etc.)
• Decreases inflammation present due to infection and apoptosis (programmed cell death)
• Improves effectiveness of antibiotics
• Promotes angiogenesis (blood vessel formation)
• Enhances the wound healing cascade
• Stimulates activated stem cell mobilization
• Stimulates new tissue growth
Physiologic mechanisms:
• Antibacterial
• Bacterial exotoxin production
• Enhances leukocyte (white blood cell) function
• Enhances production of growth factors and receptors (PDGF, VEGF, etc.)
• Decreases inflammation present due to infection and apoptosis (programmed cell death)
• Improves effectiveness of antibiotics
• Promotes angiogenesis (blood vessel formation)
• Enhances the wound healing cascade
• Stimulates activated stem cell mobilization
• Stimulates new tissue growth
1How much space is required?
The space requirements are highly variable depending on the number and type(s) of hyperbaric chambers the program design mandates. For a 2 chamber monoplace operation, the space requirements could be as little as 24 feet long by 16 feet wide (384 square feet), while multiplace operations could require several thousand square feet.
1What level of financial investment will the hospital have to shoulder?
Our program partnerships shift a significant portion of the risk and financial investment away from the facility. We provide equipment, administrative and medical direction, staff, training, and continuing education to grow centers of excellence providing comprehensive care in the management of chronic wounds.
1How can I get further information regarding the types of management programs and services HHI offers?
Please fill out the contact form and we will get right back to you.