veins, trains and automobiles

Via Christi 50+ Lunch & LearnVia Christi 50+ Lunch & Learn

Veins, trains and automobilesVeins, trains and automobiles

Marilee McBoyle, MD, FACSMedical Director

Via Christi Wound Healing and Hyperbaric Therapy1

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Today’s discussionToday’s discussion

PART 1: Veins – legs and ankles PART 2: Diabetes – feet PART 3: Trauma – legs PART 4: Hyperbaric oxygen therapy

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But first…But first…

A little bit about…

Via Christi

Wound Healing & Hyperbaric Therapy 848 N. St. Francis, on the Via Christi Hospital St. Francis campus

Via ChristiVia ChristiWound Healing & Hyperbaric TherapyWound Healing & Hyperbaric Therapy

Our staff

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Via ChristiVia ChristiWound Healing & Hyperbaric TherapyWound Healing & Hyperbaric Therapy

Our facility

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PART 1: Venous (vein) ulcersPART 1: Venous (vein) ulcers

Lower leg discomfort, swelling and ulcer development

Causes Prevention Treatment

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Interesting factsInteresting facts

Venous (vein) ulcers are the most frequent cause of leg ulcers

Leg ulcers are slow to heal and fast to recur

Chronic vein issues affect 1/3 of the adult population

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PART 1: CausesPART 1: Causes

Stasis (blood pooling)

Insufficiency

Varicose veins

Venous (vein) ulcersVenous (vein) ulcers

Varicose veins

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CEAP scale for varicose veinsCEAP scale for varicose veins

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C2

C3

C4

C5-6

Swelling

V. veins

Skin

Changes

Ulcers

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Causes of venous (vein) ulcersCauses of venous (vein) ulcers

Malfunctioning valves

Blood pools

Hemosiderin staining

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Causes of venous (vein) ulcersCauses of venous (vein) ulcers

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Malfunctioning valves

Causes of venous (veins) ulcersCauses of venous (veins) ulcers

Hemosiderin staining

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Lower leg

Prevention of venous (vein) ulcersPrevention of venous (vein) ulcers

Muscle calf pump

Compression hose

Avoid long periods of standing

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Treatment of venous (vein) ulcersTreatment of venous (vein) ulcers

Debridement

Compression

Skin substitutes

Minimally invasive procedures

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Treatment of venous (vein) ulcersTreatment of venous (vein) ulcers

Debridement

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Treatment of venous (vein) ulcersTreatment of venous (vein) ulcers

Compression: 2-layer or 4-layer wraps

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Treatment of venous (vein) ulcersTreatment of venous (vein) ulcers

Skin substitutes

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Ankle: Before

Ankle: After

We want to avoid this!We want to avoid this!

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Lower leg

Ankle

Part 2: Diabetic UlcersPart 2: Diabetic Ulcers

CAUTION:

40-70% of all lower extremity amputations are related to diabetes.

85% of diabetic-related amputations are preceded by a diabetic foot ulcer.

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PART 2: Diabetic ulcers, causesPART 2: Diabetic ulcers, causes

Injury to blood vessels

Neuropathic (can’t feel your feet)

Charcot foot

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Causes of diabetic ulcerCauses of diabetic ulcer

Neuropathic (can’t feel your feet)

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Causes of diabetic ulcersCauses of diabetic ulcers

Charcot foot

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Prevention of diabetic ulcersPrevention of diabetic ulcers

Blood sugar control / Hb A1C

Correct shoes

Checking feet every day (Including the sides and bottom of feet, and in between the toes)

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Treatment of diabetic ulcersTreatment of diabetic ulcers

Debridement

Culture

Blood sugar control

Off-loading

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Treatment of diabetic ulcersTreatment of diabetic ulcers

Debridement

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Bottom of foot: Before

Bottom of foot: After

Treatment of diabetic ulcersTreatment of diabetic ulcers

Diabetic education – for blood sugar control

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Treatment of diabetic ulcersTreatment of diabetic ulcers

Off-loading

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Bottom of footLower leg cast

PART 3: Traumatic woundsPART 3: Traumatic wounds

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Traumatic woundsTraumatic wounds

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Ankle

Shin

PART 4: PART 4: Hyperbaric Oxygen (HBO) therapyHyperbaric Oxygen (HBO) therapy

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What is Hyperbaric Oxygen therapy?What is Hyperbaric Oxygen therapy?

100 percent oxygen given with increased pressure

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Who is a candidate for HBO?Who is a candidate for HBO?

Most frequent indications

Deep diabetic foot ulcers

Radiation induced soft tissue injury

Chronic refractory Osteomyelitis

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What to expect with HBOWhat to expect with HBO

Hyperbaric oxygen therapy treatments take about two hours

You may feel pressure in your ears, similar to traveling on a plane

Glass windows are built into the hyperbaric chamber, so you can watch TV or a movie

In case of claustrophobia, medication can be prescribed

Treatment schedules vary, based on your progress

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Celebrating wound healingCelebrating wound healing

“Let the rest of

your life be the

best of your life”

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Summary and questionsSummary and questions

Marilee McBoyle, MD, FACSMedical DirectorVia Christi Wound Healing and Hyperbaric Therapy

848 N. St. Francis, Suite 1900

Wichita, KS 67214

316.268.5881

viachristi.org/wound

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