Enhancement of Healing in Selected Problem Wounds

Problem wounds represent a significant and growing challenge to our healthcare system. The incidence and prevalence of these wounds are increasing in the population resulting in growing utilization of healthcare resources and dollars expended. Venous leg ulcers represent the most common lower extremity wound seen in ambulatory wound care centers with recurrences frequent and outcomes often less than satisfactory. Pressure ulcers are common in patients in long term institutional care settings adding significant increases in cost, disability, and liability. Foot ulcers in patients with diabetes contribute to over half of lower extremity amputations in the United States in a group at risk representing only 3 per cent of the population (1). In response to this challenge specialized programs have emerged designed to identify and manage these patients using a variety of new technology to improve outcomes. Hyperbaric oxygen treatment has been increasingly utilized in an adjunctive role in many of these patients coinciding with optimized patient and local wound care.