Every day at BMH a dozen or so people make their way down a hospital corridor to the light-filled and welcoming Center for Wound Healing. Some walk slowly, assisted by canes or walkers, some use wheelchairs, and some rely on assistance from others to make the trek. Center staff members greet most of them by name; they know them well as regular participants in an intensive program to regain mobility and independence from chronic wounds. These types of wounds are associated with a number of underlying causes including diabetes, poor circulation, infections, or damage to tissue from radiation therapy. What all these patients have in common is that their wounds have not healed within a predictable pattern or time frame and they have turned to the Center for help.
Caught in a brief moment between seeing patients Greg Gadowski MD, the Center’s Medical Director reflects on the Center’s unique approach to wound care and the impact it’s had on the lives of his patients.
“What makes our program special is that we focus on the patient as a whole person, not just their wound, and we draw on the experience of a team of clinicians with expertise in many areas – general surgery, vascular surgery, internal medicine, emergency medicine, dermatology and plastic surgery,” says Gadowski “But what also sets our program apart is the level of commitment we ask of our patients. Our patients typically need to come here many times in a week, over the course of many weeks and they need to pay very close attention to the underlying medical issues that have contributed to their non-healing wound. It’s hard work, but we support them through every step of the process.”
Patients at the Center receive an individual assessment and treatment plan that addresses not just the wound in question but also other health and lifestyle issues that may be affecting their ability to heal. “Problem wounds don’t heal for a reason,” comments Gadowski. “Our job is to design and provide treatment protocols that address those reasons. Often there are other medical issues at play, or there may be obstacles in a patient’s ability to care for themselves that need to be looked at.”
Recovery from a chronic wound can be a long and arduous process, complicated by the realities of daily life. “Often we instruct patients not to bear any weight on the affected limb,” says Gadowski. “But if someone lives alone and doesn’t have caretaking support that can be a very difficult instruction to follow.” In addition to the medical issues patients must overcome, other factors can present obstacles to wound healing. Patients may not have transportation to get them to appointments on a regular schedule, they may lack the assistance they need to manage their dressing care or treatment protocols at home, or they may be habitual tobacco or alcohol users – further impeding a body’s ability to heal.
The Center often collaborates with other BMH departments like the Community Health Team and the Diabetes Program to address some of these issues. Certified Diabetic Educators, Registered Dieticians, social workers and the Visiting Nurse Association are available to assist patients in resolving some of the issues that have been barriers to healing and provide support for developing healthier habits. Education also plays a key role in wound healing. “It’s important that patients know how to best manage their disease in order to prevent complications that might bring them to the Center,” says Gadowski. “Many diseases like diabetes can affect the body’s immune system and the way it fights infection, so we stress the importance of taking the best care possible of chronic illnesses so that wounds don’t have a chance to develop in the first place.”
Gadowski finds the work very satisfying “We’re healing people at a much faster rate and returning them to a more mobile and healthy lifestyle. We’re helping a lot of lives.” He is encouraged to see patients returning to their favorite pastimes and regaining mobility. “Chronic wounds can really limit your lifestyle,” he notes, “So when I see our patients being able to take a walk, or drive themselves to the supermarket — especially since I know what an extraordinary commitment they have made to their healing – that’s very gratifying.”
He encourages anyone with a concern about a chronic and non-healing wound to contact the Center for more information. “They can get a referral from their primary care practitioner, but they can also contact us directly. We see patients as quickly as we can, often within a day, so we can start them on the road to healing as quickly as possible.” Anyone interested in finding out more about the services offered by the Center can contact them at 802-275-3674.
Gregory Gadowski, MD, is the Medical Director for the Brattleboro Memorial Hospital Center for Wound Healing and a board-certified surgeon practicing at Brattleboro General Surgery. For more information call 802-275-3674 or visit online at www.bmhvt.org.