Types of Wounds
Persistent non-healing wounds come in many forms. Depending on the type of wound your physician will prescribe from any number of different courses of treatment. Some wounds, such as pressure sores, diabetic ulcers, and vascular ulcers may require surgical debridement, which is the removal of weakened or dead tissue. Reconstructive surgery is also a possibility for wound repair.
Diabetic wounds and ulcers often occur on lower extremities and are frequently associated with diabetic neuropathy also known as a decrease in sensation. Diabetic ulcers can be quite severe and sometimes lead to surgical amputation. Diabetic wounds often require management by more than one physician. A surgeon will work in conjunction with your care team if surgery to remove or reconstruct the wound is necessary.
Skin and soft tissue cancers related to chronic wounds are a frequently under-recognized cause of non-healing. The appearance of a cancerous wound can be fairly unexceptional; as such chronic non-healing wounds that have not responded to traditional wound care regimens benefit from assessment by a wound specialist. The wound care specialist may biopsy, or sample, the soft tissue of the wound for further analysis.
Pressure ulcers develop when external pressure over a bony area cuts off the supply of oxygen and nutrients to soft tissue like skin or muscle. This results in tissue damage. Over time, issues can range from treatable wounds to outright death of the tissue.
The skin is more tolerant to pressure than the underlying fat and muscle. Pressure-related skin changes are the “tip of the iceberg” compared with the extent of the underlying tissue damage. Common locations for press ulcers can be the lower back, tail bone, buttocks, heels, back of the head, and the sitting bones.
Radiation-induced tissue injury is a common side-effect of radiation therapy. Tissue changes can occur suddenly or long after therapy is completed and usually appears at the site of treatment but can also appear in the soft tissue nearby.
Radiation related wounds can also develop because of minor trauma to the radiated tissue. Surgical incisions within radiated tissue may also have difficulty healing resulting in an open wound.
For some patients, hyperbaric oxygen therapy (HBOT) can be prescribed in addition to conventional medical and surgical care for radiation related tissue injury.
Vascular ulcers are wounds which usually occur below the knee as a result of a decreased blood flow and can affect one or both legs. Vascular ulcers are common in patients who have a history of swelling in their legs, varicose veins, or blood clots. Like diabetic ulcers, management usually requires more than one doctor – for example, a surgeon will work in together with caregiver if surgery is required.
Treatments & Services
Cleveland Clinic’s Wound Healing Centers offer wound care management in an outpatient setting and several facilities feature hyperbaric chambers. The centers use a multi-disciplinary approach to wound healing and provide complete wound care services to those suffering from diabetic ulcers, pressure ulcers, compromised skin grafts and flaps, and wounds that haven’t healed within 30 days.
There are many facets of wound care and we offer just as many very specialized treatments, resources and options to help get you on the road to healing.
Diabetes Related Wounds
The most common chronic complication of diabetes is diabetic neuropathy, a serious nerve disorder that affects the legs and feet, and causes ulcerations, infections and, in advanced cases, amputation.
Without proper prevention or early detection with proper treatment, diabetic neuropathy can lead to severe complications.
Hyperbaric Oxygen Therapy
Hyperbaric Oxygen Therapy (HBOT) is a medical treatment in which the body is exposed to 100% oxygen while under increased atmospheric pressure. HBOT must be used in addition to standard wound care and is usually recommended when there is no measurable signs of healing after at least 30 days of treatment with standard wound therapy.
During an HBOT treatment, you can sit back, relax, read, nap or watch a movie; the only physical sensation you may feel is slight pressure in your eardrums.
HBOT is used to treat a variety of conditions:
- Crush injuries and severed limbs
- Peripheral arterial insufficiency (muscle pain or cramping in limbs caused by physical activity)
- Chronic refractory osteomyelitis (persistent bone infection after treatment for osteomyelitis)
- Osteoradionecrosis (radiation injury to the bone)
- Injury to the soft tissue caused by radiation
- Actinomycosis (inflamed tissue in the mouth or jaw)
- Diabetic wounds of the lower extremities in people who:
- Have type I or type II diabetes and a lower extremity wound that is due to diabetes
- Have a wound classified as Wagner grade III or higher, which could be classified as gangrene.
- Have received an unsuccessful course of standard wound therapy.
A referral from a physician is required for HBOT.
Lower Extremity Wounds
At The Wound Care Clinic in the Sydell and Arnold Miller Family Heart & Vascular Institute, we use a broad-based approach to treat wounds by a team of experts.
The first step is to find the underlying cause of the problem. Lower extremity wounds, such as leg and foot sores, can be caused by one or a combination of problems including poor circulation, diabetes and other medical problems.
Negative Pressure Therapy
Negative pressure wound therapy (NWPT) is a type of wound care treatment that can be used for wounds on most parts of the body.
Physical Therapy Wound Treatments
Physical therapists are on the front lines of wound management in many healthcare settings. They possess in-depth knowledge of anatomy and tissue healing as well as mobility and positioning expertise. The wound care therapy staff will work with your medical team utilizing the most advanced wound care protocols available.
The skin is a seamless organ protecting the body from infection. Throughout our lives we have experiences that injure our skin, leaving behind a scar. Scars depend on many factors.
Wound Ostomy Care at Home
Our Wound Ostomy and Continence team can treat you or your loved one in your home, assisted living facility or a skilled nursing facility. We have extensive training in wound care and healing, ostomy care and continence issues and will work closely with your medical team to provide the most effective and efficient treatment for your needs.
The Cleveland Clinic Wound Healing Center offers a variety of services throughout the healthcare system. There are several dedicated Wound Healing Centers around the region that focus specifically on the multi-disciplinary approach providing all aspects of wound healing expertise and services.
Same-day consultations are available at these dedicated Wound Healing Centers:
- Euclid Hospital
- Hillcrest Hospital
- Lutheran Hospital
216.363.5790 or 866.566.9670 (toll-free)
- Medina Hospital
330.721.5126 or 866.263.2967 (toll-free)
- South Pointe Hospital
216.491.7111 or 866.408.9309 (toll-free)
Additional Wound Services
Additional wound services are available at these Cleveland Clinic locations:
- Avon Lake Family Health Center
- Beachwood Family Health and Surgery Center
- Independence Family Health Center
- Marymount Hospital
- Strongsville Family Health and Surgery Center
- Stephanie Tubbs Jones Health Center