Published on August 27, 2010

Healing Wounds With Hyperbaric Medicine

Genesis Wound and Hyperbaric Medicine Institute enjoys a successful first year

To many, the words “hyperbaric chamber” may conjure up images of claustrophobic cylinders similar to the iron lungs used by polio patients or the early MRI machines.

Technology is turning around that stereotype, however. Today, patients who use the new hyperbaric chambers at the Genesis Wound and Hyperbaric Medicine Institute enjoy the largest single-person chambers now being produced in the U.S.

The 41-inch-wide chambers offer ambient light. Chronic wound patients can comfortably undergo hyperbaric oxygen therapy while sipping on a refreshment and watching a flat-screen TV that sits outside and atop the machine, with audio piped into the chamber. They lie in a recumbent position, similar to reclining on a sofa.

It’s one of many cutting-edge ways the Institute has responded to the explosive growth of patients with hard-to-heal wounds -- a phenomenon that’s directly related to the national epidemic of obesity, diabetes and heart disease. This month, the institute celebrates its one-year anniversary.

Exceeding Expectations
A year ago, Genesis launched a collaboration with physician consultants Brad DeWall, M.D., and Richard Sadler, M.D., two longtime surgeons and wound care specialists who oversee the program’s day-to-day operations. The two brought hyperbaric oxygen therapy to Genesis as part of a planned renovation and service expansion. Lori Riessen, R.N., WCC, became the wound institute’s program director.

Wound care services remained in Pavilion 2 of Genesis Medical Center’s West Central Park campus in Davenport and expanded into an adjacent area to make room for the state-ofthe- art hyperbaric chambers.

The partnership has exceeded expectations: Each month, the wound center sees 700-800 patient visits and gives 180-200 hyperbaric treatments. The hyperbaric chambers represent the newest models by Sechrist Industries and the largest monoplace, or single-person, chambers in production.

During hyperbaric oxygen therapy, patients are placed inside a pressurized chamber of 100 percent oxygen. The painless therapy delivers high concentrations of oxygen to the bloodstream, accelerates wound healing and fights certain types of infections. It also stimulates the growth of new blood vessels and improves circulation.

“Often, people with chronic wounds have an inability to deliver a high enough oxygen level to the tissues to heal the wound,” Dr. Sadler said. “With hyperbaric oxygen therapy, we can boost their oxygen at a cellular level. We’re actually increasing the patient’s own blood concentration of oxygen.”

Patients are generally in the chamber for 90 minutes to two hours. They receive 20-40 treatments -- one treatment a day, five days a week.

Being inside the hyperbaric chamber is akin to being inside a commercial aircraft, where patients feel pressure in their ears from ascending and descending and feel the need to clear them.

At first, some patients are intimidated by the hyperbaric chamber, Dr. DeWall said. Over the years, however, the demand for patient comfort has increased the size of the hyperbaric chambers, he said, similar to the way the larger, open MRIs have responded to the fears of claustrophobic patients.

“I use the analogy of going on a roller coaster,” Dr. DeWall said. “The first time you go on the roller coaster, you’re more anxious and you don’t know what’s coming. Once you’ve taken that ride once, you get right back on again, and think, ‘Hey, that wasn’t so bad.’ Overall, our patient response has been very good.”

Treating the foot wounds of diabetes patients is the most common use for hyperbaric medicine. Today, Medicare approves hyperbaric medicine for 13 diagnoses, ranging from diabetic foot wounds and arterial insufficiency wounds to radiation necrosis.

“A lot of patients with diabetes have wounds in the lower extremities, and hyperbaric medicine can help them avoid an amputation,” Dr. DeWall said. “Before they come to us, a lot of patients have been told that amputation is a ‘treatment option.’ At Genesis, we consider amputation to be a ‘treatment failure.’ We address many wounds, and our goal is to save the extremity.”

About 10-11 percent of patients treated in the wound clinic will also undergo hyperbaric therapy to augment the healing process.

Increased Prevalence
“The Centers for Disease Control says the prevalence of chronic wounds is four times that of coronary disease in the United States. It’s a huge problem, and there’s a growing awareness of the importance of wound care,” Dr. Sadler said.

But also driving patient volumes at the Genesis Wound and Hyperbaric Medicine Institute is a focus on patient safety and a real passion for wound care among its staff and leaders, he said. “Within a visit or two, they’ve figured it out. Our patients and referring physicians feel a real sense of engagement from our nursing and physician staff,” Dr. Sadler said.

Dr. DeWall added: “Our management and patient care is driven by physicians, and we do that in partnership with the hospital. We take ownership in the quality of care we bring to this facility. For example, we’re striving to have all of our physicians and nurses certified in wound care and the appropriate doctors certified in hyperbaric medicine. Here, the bottom line is quality and outcomes, and that is why we’re seeing 700-800 patient visits a month.”

The physicians’ passion for wound care evolved over the years after seeing the physical and emotional ramifications that chronic wounds can have on patients.

“With a chronic wound comes chronic pain that disrupts sleep and is hugely stressful to the hormone system, cortisol levels and the entire immune system,” Dr. Sadler says. “It’s very subtle, but also very corrosive to the stress level. It’s always there; it’s a constant wear on the patient; and, in my opinion, I think this chronic stress shortens life.”

Patients with chronic wounds also have to worry about odor, what to wear to accommodate their wound and how to sit, stand or go out in public. Such issues can make them socially reclusive.

“These wounds are life-altering,” Dr. DeWall concludes. “There are so many people with chronic wounds, and there aren’t a lot of people out there helping them. There isn’t a day I go home that I don’t feel like I’ve helped somebody. It’s extremely fulfilling.”

For information on the Genesis Wound and Hyperbaric Medicine Institute or to make an appointment, call (563) 421-1585.