|
 |
| |
Hospital
Comprehensive Wound
Healing Center which was
affiliated with Praxis Clinical
Services. |
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|
Soft Tissue |
|
Radionecrosis |
|
| Center
for Wound Healing |
| and
Hyperbaric Medicine |
| 240
Williamson Street, Suite 104 - Elizabeth, NJ 07207 |
| (908)
994-5480 |
|
PATIENT:
48 y.o. male, history of wound on left shoulder x 20 years. |
WOUND HISTORY:
12/99 Physician examination described “a huge, foul-smelling,
necrotic, invasive tumor that measures 17cm x 17cm x 5cm.” Patient refused
surgical intervention.
1/00 Radiation begun, continued through mid-April total dose
7020cGy. Dressings were saline gauze and hydrogen peroxide gauze.
4/11/00 CT of shoulder reveals ulcerating mass of left shoulder, no
evidence of adenopathy.
6/16/00 Resection of shoulder area, involving clavicle, surrounding
muscles to brachial plexis with resultant large soft tissue defect treated
with wet-to-damp saline dressings.
6/28/00 Regional flap rotatation and STSG closure.
7/9/00 Discharged home with small separation between graft and
neck, instructed to continue saline gauze dressings. |
CLINICAL CHALLENGE:
Long-standing, neglected defect, post-surgical and radiation intervention
in a
non-compliant subject with ETOH abuse, 1-1 1/2 ppd smoker |
RESULTS:
HBO2 discontinued after 39 treatments. No further skin grafting needed. |
|
Referral
Information |
Patients should be referred to the Center for
Wound Healing and Hyperbaric Medicine at Trinitas Hospital for
aggressive, outcome based wound management. Our center is
designed to compliment the attending physician’s services by providing
expert wound management consultation and care including the
application of advanced wound care technology and hyperbaric oxygen
treatment as indicated based on a comprehensive system of evidence
based clinical practice guidelines. The referring physician will
continue to treat comorbid conditions and provide for the patient’s
overall medical care. Hyperbaric oxygen treatment is available
specifically for the treatment of soft tissue radionecrosis,
osteoradionecrosis, osteomyelitis, clostridial myonecrosis and other
necrotizing soft tissue infections, compromised skin grafts and flaps,
crush injuries and other acute traumatic ischemias, and diabetic
wounds of the lower extremities. All etiologies of wound healing
failure are accepted for evaluation and care.
Types of wounds treated include
Diabetic, Venous Stasis, Ischemic, Pressure, Traumatic, Surgical and
other wounds that resist healing. |
Problem wound patients should be referred to
the Center when:
 The
wound has failed to show significant progress in 4 weeks of standard
care
When
the wound involves deep tissue structures or is limb or life
threatening
When
the wound is complicated by significant comorbidities including
peripheral
vascular disease, persistent edema, persistent infection,
prior radiation treatment
to the area, or compromised immune status of the patient
To refer a patient, please call
(908) 994-5480 or visit us at
www.trinitashospital.com |
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