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Hard-to-Heal Wounds: Read Fred's Story
Date: 11/4/2010

When Fred Knox, a retired truck driver from Trenton, was diagnosed with diabetes, he made a life change.  "When I got diabetes, I knew what was important.  I got on the medication and worked to change what I was eating.  I started to walk a lot for exercise."

Monitoring glucose levels, managing medication, watching your diet and exercising are all elements of self-care that have to be worked into a daily routine for someone with diabetes.  Yet, there are also health challenges that come along which mostly catch people with the disease by surprise.

"I went into the emergency room at another hospital," recalls Fred.  "They kept me because they thought it was my heart. Then I got these sores on my heels. They should've been moving me.  When I got out, I was left with this pain."

Many people with diabetes are like Fred. "They suffer from poor circulation, a decreased immunity and a lack of sensation in their feet called neuropathy," says vascular specialist Biagio Manna, DO, co-medical director of the RWJ Hamilton Center for Wound Healing. "This makes the lower extremities susceptible to unnoticed injuries, skin breaks and subsequent infections."

The key is to watch your feet, checking your heels and between your toes. Build this into your routine as you ready for bed or put your socks on. Stay aware of how your skin feels and looks. If a wound has not healed in four weeks, seek medical help.

"If left untreated or treated improperly, chronic wounds can lead to complications," adds the center's other medical director Reza A. Shah, DO, FAPWCA. "Some people we see are quite serious. It can affect one's quality of life forever."

Wound, Heal Thyself

The body has a way of healing itself, and while assistance may be required, all wounds heal the same way. Open wounds build up new tissue, providing a base of support for the re-growth of skin. If you have a disease like diabetes or a skin infection, the new tissues grow much slower. 

"As a wound care team, we first determine what is causing the wound not to heal and eliminate or control these factors. We work to provide optimal conditions including fluid and nutritional support. Finally, we keep the wound site clean and remove nonviable tissue, keeping away infection."

A Recipe for Success


While the body's healing process is generally the same, each patient's wound is unique. Whether through traditional or advanced therapies, there is often a recipe for success.

"With the protocols we have instituted, our patients are experiencing incredible results. There are hundreds of dressings, some with special gels, and at this center, we are using state-of-the-art tools such as genetically engineered synthetic skin and hyperbaric oxygen treatment." Treatment may also include physical therapy, nutrition counseling and patient education.

Dr. Shah says these new tools have moved the needle in wound care. "I am helping a woman who was unsuccessfully treated at a major Philadelphia academic medical center. They were one of the first to have a wound center, but it is a matter of using the right protocols. Today, she has use of her hand for the first time in a year."

"When you're talking about that kind of improvement or being able to help someone keep a leg, imagine how their life can change."

Fred knows this first hand. "The pressure on my heels was too much. It's frustrating when your skin does not heal, but you have to be patient and follow instructions. The hyperbaric is really helping.  My metabolism is up and my blood pressure is lower. I feel great."


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