Overview

Overview

The wound care specialists at Cleveland Clinic in Florida can help if you have a wound that won’t heal. Nonhealing or chronic wounds are those that don’t improve after four weeks of treatment. They are often painful.

Prompt treatment is key to preventing potentially life-threatening infections. We offer advanced diagnostic tests and the latest treatments for all types of nonhealing wounds.

Wound Care at Cleveland Clinic in Florida: Why Choose Us?

Our team provides expert inpatient and outpatient wound care services that promote healing and lower your risk of complications. You benefit from:

  • Comprehensive diagnostic tests: Pinpointing the cause of a wound — and why it’s slow to heal — is vital for effective long-term treatment. We perform in-depth wound assessments and diagnostic tests. Learn how we diagnose nonhealing wounds.
  • Focus on vascular health: Poor blood flow can lead to chronic wounds and slow healing. Our wound care services are part of vascular medicine, which focuses on blood circulation issues. You receive care from a vascular-trained wound specialist. This level of expertise at wound centers is rare. See the conditions we treat.
  • Advanced wound treatments: We take a whole-body approach to healing that helps even the most difficult-to-treat wounds. You benefit from wound debridement (surgical removal of damaged tissue), hyperbaric oxygen therapy, personalized nutrition counseling and other therapies. Discover our wound treatments.
  • Care for all types of ostomies: We’re among a select few health systems in the region providing preoperative and postoperative services for people with ostomies. We help you manage your self-care and provide wound-healing therapies as needed. Learn about ostomy care.
  • Certified wound and ostomy specialists: Caring for nonhealing wounds and ostomies requires specialized expertise. You receive care from nurses certified through the Wound, Ostomy and Continence Nursing Certification Board.
  • Patient-centered care: We partner with you, your caregivers, home healthcare teams and medical suppliers to ensure proper wound and ostomy care at home. You also have access to wound and ostomy services at Cleveland Clinic in Florida hospitals and outpatient locations.

Team approach to wound care

You receive advanced care from a dedicated team that may include experts from these medical specialties:

Nationally recognized medical services

Cleveland Clinic in Florida hospitals consistently rank among the best in the state. Learn more about our recognitions and rankings.

What We Treat

What We Treat

Our wound care specialists offer expert therapies for even the most difficult-to-heal wounds. We use the latest, most advanced methods to help you heal while lowering your risk of complications.

Types of nonhealing wounds

We offer expert care for all types of chronic, slow-healing wounds:

Causes of nonhealing wounds

These conditions and treatments can affect blood flow, slowing the wound healing process:

Complications of nonhealing wounds

Bacteria and other germs can enter a wound, causing these serious complications:

Diagnostic Tests

Diagnostic Tests

At Cleveland Clinic in Florida, we focus on finding the cause of a wound and why it’s slow to heal. This information helps our team develop a treatment plan that promotes healing and lowers the risk of a wound recurring.

Tests for nonhealing wounds

Your provider thoroughly reviews your medical history and physically examines you, including a head-to-toe skin check.

You may also get one or more of these diagnostic tests:

  • Ankle-brachial index (ABI) test: An ABI test measures blood pressure in your ankles and arms to determine if you have peripheral artery disease (PAD).
  • Arterial duplex ultrasound (Doppler ultrasound): Sound waves from a handheld ultrasound device show blood flow and blockages.
  • Biopsy: A wound-edge biopsy of tissue cells and fluid samples checks for changes in rare or unusual wounds and tissue masses (neoplasms).
  • Blood tests: Blood tests help determine if certain diseases are affecting wound healing. These tests may assess glucose, autoantibodies and other disease markers.
  • Other imaging tests: CT scans, MRIs and X-rays assess blood flow, blood vessel damage and infections.
  • Venous incompetency study: A vascular test checks for damaged valves in veins that slow healing. This test also shows if certain procedures can speed wound healing and prevent a wound recurrence.
  • Wound culture: A wound bacterial culture test checks fluids for signs of infection.
Wound Treatments

Wound Treatments

You may need a combination of treatments, depending on the cause and severity of the wound. Even with advanced care, some wounds can take months or longer to heal fully. We offer inpatient and outpatient wound care therapies.

We offer a full range of wound treatments:

  • Wound debridement.
  • Hyperbaric oxygen therapy (HBOT).
  • Negative pressure wound therapy.
  • Nutrition counseling.
  • Offloading and total contact casting.
  • Vascular procedures.
  • Other wound treatments.

Wound debridement

During wound debridement, a physician or wound-certified nurse removes damaged, dead or infected skin tissue. This step helps promote the growth of new, healthy skin.

You may receive local anesthesia to numb the area or general anesthesia if the treatment site is large. Procedures take place at our outpatient locations, hospital rooms and surgical facilities.

We offer all types of wound debridement:

  • Autolytic debridement: Specialized bandages help the body use its own fluids to heal a wound.
  • Enzymatic (chemical) debridement: Your provider applies a topical gel or ointment to the wound that contains enzymes (proteins) that promote healing.
  • Sharp debridement: Your provider uses a scalpel or other sharp instrument to remove damaged tissue.
  • Ultrasound debridement: Your provider uses an ultrasound device to deliver sound waves that remove damaged tissue.

Hyperbaric oxygen therapy (HBOT)

During hyperbaric oxygen therapy (HBOT), you breathe in 100% pure oxygen. That’s about five times the amount of oxygen in the air you usually breathe. Your blood cells absorb this extra oxygen and carry it to the wound site, speeding the healing process.

Increased blood oxygen levels promote wound healing by:

  • Stimulating the release of substances called growth factors that help form new skin, blood vessels and connective tissues.
  • Preventing and fighting bacterial infections.

We offer hyperbaric oxygen therapy at the David L. Smythe Wound Center in Stuart and the Indian River Hospital Ambulatory Services Center/Wound Healing Center in Vero Beach.

This treatment involves:

  • Sitting or lying down inside a pressurized chamber.
  • Breathing pure oxygen infused inside the pressurized chamber.
  • Participating in 1- to 2-hour HBOT sessions multiple times per week as your provider prescribes.

Negative pressure wound therapy

Negative pressure wound therapy (also known as vacuum-assisted closure) uses suction to remove excess fluid from a wound. Fluid removal lowers infection risk. The suction also helps bring more oxygenated blood to the injured tissue.

This treatment may take place in the hospital or at home. The vacuum device is small, portable and discreet. You can go about your usual activities while the attached device treats the wound. You may need this treatment for a few weeks or months.

Negative pressure wound therapy involves:

  • Debriding the wound.
  • Packing the wound with sterile foam.
  • Covering the wound with a clear, airtight dressing.
  • Attaching a small vacuum pump to the dressing.
  • Activating the negative pressure (suction) to pull fluids away from the wound and into a reservoir.
  • Emptying the reservoir and changing the dressing as needed.

Nutrition counseling

Your body needs more energy (calories), protein and fluids to heal a chronic wound. You also need a healthy balance of vitamins, minerals and antioxidants. Our registered dietitian nutritionists specialize in wound healing. They partner with you to customize a dietary plan that ensures proper nutrition for healing. We offer in-person and virtual nutrition counseling.

Offloading and total contact casting

Offloading — taking pressure off a lower limb wound — allows blood to reach the wound more easily, speeding healing. We may prescribe a wheelchair, knee scooter or crutches.

Patients with diabetic foot ulcers benefit from total contact casting. This evenly distributes weight over the full surface of your foot, easing pressure on ulcer-prone areas. Our wound care specialists have advanced training and certifications in total contact casting from The American Society of Orthopedic Professionals.

Total contact casting involves:

  • Treating the wound and bandaging the entire foot.
  • Applying a fiberglass or plaster cast that encases the entire foot (including toes) and extends to below the knee.
  • Wearing a brace over the cast and using crutches to get around.
  • Seeing your provider, who changes the cast and bandages every week for up to eight weeks or until the wound heals.

Vascular procedures

Some people need vascular surgery or other venous disease treatments to restore blood flow to the legs. Our vascular team specializes in all types of vascular surgeries, including:

  • Angioplasty to open a blocked blood vessel and place a stent (small metal tube) to keep it open.
  • Vascular disease bypass surgery to reroute blood flow around blocked arteries.
  • Venous ablative procedures to eliminate damaged venous valves and promote wound healing.

Other wound treatments

Your treatment plan may also include:

  • Medications: You may need antibiotics to prevent or treat bacterial infections. Some people may also need pain relievers (analgesics).
  • Skin substitutes: A lab-made, tissue-based product covers a wound to keep out germs that cause infections.
  • Skin grafts: A skin graft is a surgical procedure that replaces damaged skin with healthy skin removed from a different part of your body.
  • Vitamins or nutritional guidance: You may benefit from vitamins or specific foods recommended by your care team to decrease inflammation associated with certain wounds.
Ostomy Care

Ostomy Care

We’re among a select few health systems in the region providing dedicated care for patients who undergo ostomy procedures. You receive compassionate care from nurses who are triple certified in wound, ostomy and continence (WOC) care by the WOC Nursing Certification Board.

Our high volume of patients gives us deep ostomy experience. We’re experts at helping patients who are medically frail and those who need ostomy revisions or closures. You benefit from preoperative and postoperative ostomy care, as well as advanced wound healing treatments.

What is an ostomy?

An ostomy is a surgical procedure that creates an opening in your abdomen (called a stoma) for feces or urine to leave your body. A pouch attached to the stoma collects this waste, which you empty. You may need a temporary or permanent ostomy if you have a condition that damages part of your digestive system or urinary system.

Ostomy types

We provide advanced care for all types of ostomies:

  • Colostomy: The stoma connects to your colon (large intestine) to get rid of solid waste. You may need a colostomy after a colectomy, which removes part or all of your colon. Specialists at our nationally recognized colorectal surgery program perform this procedure.
  • Ileostomy: The stoma connects to the last part of your small intestine (ileum) to remove solid waste. You may need an ileostomy after a colectomy, a surgery that removes part or all of your large intestine.
  • Urostomy: The stoma connects to your large intestine to create a urinary diversion. You may need a urostomy after a cystectomy. Our highly skilled urology surgeons perform this procedure, which removes all or part of your bladder.

Ostomy Services We Provide

Learning that you need an ostomy can be upsetting. You may have concerns about how an ostomy will affect your ability to participate in activities and enjoy life. But many people live a good life with a stoma following an ostomy.

Our team has deep experience helping patients learn to care for and embrace life after an ostomy procedure. We partner with you and your loved ones to ensure an ostomy doesn’t hold you back.

We provide a full range of ostomy services for all patients, including those who are medically frail or have complex conditions. You benefit from:

  • Preoperative ostomy services.
  • Postoperative ostomy services.
  • Ostomy support services.

Preoperative ostomy services

A WOC-certified nurse meets with you and your loved ones a few days before the ostomy procedure. This preoperative appointment helps you prepare for surgery and postoperative recovery. To streamline your care, you may also get lab work and see other specialists on the same day.

Preoperative ostomy services include:

  • Ostomy education: We explain the ostomy procedure, including what to expect after surgery and when you go home. You also learn how to care for the stoma, as well as how to empty and reapply the pouch.
  • Stoma marking and assessment: We determine the best placement for the stoma and pouch system based on your unique body shape, occupation, clothing preferences and activities. We also evaluate how you walk to ensure the stoma won’t affect your ability to move freely. We then use a marker to note the location for your surgeon.
  • Pouch appliance evaluations: We use information from the stoma assessment to select the best pouch system for you. We may apply a mock stoma and pouch system to the marked site so you can get an idea of how your body will look and feel after surgery.

Postoperative ostomy services

After surgery, you’ll recover in the hospital for approximately five days.

Two days after surgery, a WOC-certified nurse will:

  • Evaluate the stoma for signs of infection and provide treatments to promote proper healing.
  • Remove a temporary rod that some patients need to stabilize the stoma in the abdomen.
  • Remove and replace an ostomy pouch while you observe the steps.
  • Check on how you’re coping emotionally and connect you with mental health support, if needed.

Before you leave the hospital, a WOC-certified nurse will:

  • Watch and provide instructions as you practice removing and replacing the ostomy pouch.
  • Answer your questions about at-home ostomy care.
  • Ensure you’re set up with medical supplies and home healthcare services.
  • Explain what to expect when you get home.
  • Make sure you know the signs of infection and when to call your provider.

After you go home, you will:

  • Receive home healthcare services.
  • Receive a call from us to see how you’re doing. You can always call us with any questions or concerns.
  • Come in for a check-up approximately two weeks after discharge.
  • Get assistance with medical supply companies, if needed.
  • Receive ongoing care to prevent infections and other complications.

Ostomy support services

Learning to care for and live with an ostomy can take time. Some people feel depressed or anxious. To help you cope, we offer:

  • In-person support group led by a WOC-certified nurse.
  • Mental health counseling.

Other treatments

We also offer wound treatments for:

  • Fistulas (abnormal openings that form between your skin and an organ or blood vessel).
  • Ostomy-related skin irritations or infections.
  • Pilonidal cysts.
  • Stomas that need to heal after surgical revision or closure.
Our Doctors

Our Doctors

Appointments & Locations

Appointments & Locations

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Make an appointment at a Cleveland Clinic location in Florida or schedule a virtual visit. We also offer virtual second opinions.

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