By Tracy Turcotte
The Center for Wound Healing at BMH uses a case management approach to treating chronic, non-healing wounds. In my role as Clinical Nurse Manager, I also case manage a number of our patients and get to build relationships with my patients.
When a patient arrives for their first visit, we take approximately 60-90 minutes to work through their medical history and develop a course of treatment. On each visit, we take a picture of the wound and a complete set of measurements. Having these measurements and pictures assist the physician and case manager with determining the effectiveness of treatment and make decisions about the treatment plan.
Many of our patients need further testing, and if required, the physician will order labs, x-rays and additional testing, including vascular studies that determine if the wound is receiving enough oxygen to heal properly.
Approximately ten percent of the patients may be eligible for Hyperbaric Oxygen Treatment (HBOT). This is an additional daily treatment in the HBOT chambers. This special treatment requires the patient to be in the chamber for about 2 hours a day, and usually for 30 treatments. Patient is re-evaluated by the physician and more HBOT may be prescribed.
One of the procedures the physicians use in about half the visits is debridement. During a debridement the doctor removes the non-viable tissue from the wound. This helps promote the growth of healthy tissue that can assist the wound in healing.
It is important to dress the wound to keep it protected between weekly visits. While a non-healing wound can occur on many areas of the body, the vast majority we treat in the wound center are located on the lower extremities.
If off-loading is required, we can use a total contact cast (TCC-EZ®), which will offload any weight the patient may be putting on the foot. Some leg wounds require compression, and the physician will determine whether the patient needs a two, three or four layer compression wrap. The number of layers is determined by a variety of things, including edema and the patients tolerance for the continual pressure of the wrap.
The nurses and physicians at the BMH Center for Wound Healing have all received extensive and specialized training in the treatment of non-healing wounds and are continually required to demonstrate competencies in areas of wound healing.
I have been a nurse for 22 years and helping a patient to heal, is a very gratifying experience. I look forward to meeting others in the community and helping them realize they do not have to live with chronic, non-healing wounds.
Tracy Turcotte, RN is the Clinical Nurse Manager at the Brattleboro Memorial Hospital Center for Wound Healing. She can be reached at 802-275-3674.