The Weill Cornell Wound Care Center has outstanding statistics in percentages of wound healing. We consistently have one of the best percentages in the country, for many years. This is due to our excellent nurses, physicians and staff.
The physicians at the Weill Cornell Wound Care Center have years of experience in helping New Yorkers to heal from chronic wounds. The team of doctors are vascular surgeons, podiatrists, general surgeons, plastic and reconstrucive surgeons, Endocrinologists, Infectious disease doctors, Internal medicine doctors, Cardiologists, Orthotics and prosthetics specialists and specifically trained nurses and staff.
Our team treats wounds of all kinds, all causes, and on all parts of the body. We use a team approach to treat non-healing wounds.
If you suffer from non-healing wounds call us directly, or speak to your doctor about a referral to the Weill Cornell Wound Care Center. We will work with you and your own medical doctor to treat your wounds. We are an outpatient treatment center. We always communicate with your doctors. We are not here to replace your medical doctor and the specialists that you already see. We will work closely with them to get your wounds to heal. When your wounds are healed, our wound care specialist are done with their job, and patients then return to the care of their existing doctors.
Chronic wounds can be debilitating and lead to more significant complications such as the need for extended hospitalization, multiple surgeries, amputation and limb or life threatening infections. Early treatment has been proven to reduce complications, prevent amputations and allow patients to return to work and improved quality of life.
Common causes of wounds that we treat include: diabetes, neuropathy, peripheral arterial disease, venous insufficiency, lymphatic insufficiency, lymphedema, vasculitis, trauma, radiation, surgical wound dehiscence, pressure sores, bed sores, burns, infections, sickle cell disease and any other cause of non-healing wounds.
At the Weill Cornell Wound Care Center we use a comprehensive plan of care that includes your overall health, underlying diseases that causes non-healing wounds and assessment and the treatment of the wound itself. We use a team approach to accomplish this goal. This team always includes the patient through proper education of you and your family, as well as constant communication with your own medical doctor who is at the center of the coordination.
Our physicians are experts in wound healing with extensive experience and ability to recognize the reason why a wound is not healing properly. Identifying the underlying cause is the first step in getting chronic wounds to heal. This is part of the art of wound healing and only comes from experience.
Our treatment is based on the philosophy we like to call "limb preservation". Amputation is always the last option. We perform systemic and local treatments that have the goal of avoiding amputation at all costs. At the same time we always try to preserve function of the limb in order to prevent future problems and recurrence of wounds.
Unfortunately, not all limbs are salvageable. Our physicians know when to give up on limb salvage and move on to amputation in order to preserve quality of life and allow patients to move on and cope with an amputation. We work with prosthetists that specialize in allowing patients to function after amputation.
You are not alone. Millions of people suffer from chronic wounds every day. Call the Weill Cornell Wound Care Center today and start on a comprehensive plan to heal and improve your quality of life.
The William Randolph Hearst Burn Center
520 East 70th Street
7th Floor Ste. L-7
New York, NY 10065
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Diabetic neuropathy is characterized by the nerve fibers suffering damage due to diabetes. The nerves in the legs are most commonly affected and this can lead to an array of foot issues. It is not fully understood how the nerve damage occurs, but scientists believe that nerve cell metabolism is changed by high levels of glucose and this results in the blood flow to the nerves being reduced. The reduction in blood flow means that the nerves are not getting all of the nutrients that they need for optimal health.
The wounds are typically ulcers with a few distinct characteristics, including:
· The ulcer is painless
· The affected foot will still have a pulse
· The ulcer is surrounded by a callus
· The ulcer is usually located on the tips of the toes or on the bottom of the foot or any pressure point
Diabetic neuropathy leads to wounds because the patient loses the ability to feel pain due to the nerves being damaged. As a result, a lot of pressure is exerted on the area that has lost sensation when the patient walks, or wears shoes, leading to callus formation. The pressure continues to build, leading to skin breakdown and ulceration. The foot wound develops, but the patient does not notice any discomfort or pain.
Anyone who has diabetic neuropathy is at risk for developing a foot wound. However, the risk increases when the following factors are present:
· History of foot ulcers
· Medical testing shows lack of sensation in the feet
· Not following proper foot hygiene or not wearing the proper footwear
The first thing that is done is to ensure that the patient is wearing the proper footwear to prevent a worsening of the condition. To alleviate pressure, the calluses will be regularly removed from the offending foot. The wound should be kept moist during the healing stage, so a moist, foam dressing is used to prevent drying, cushion the wound and allow oxygen to get to the wound.
Since many foot ulcers are infected, an antibiotic is generally prescribed and this should be taken exactly as directed. The typical course of antibiotics for neuropathic ulcers is several weeks long. The foot should be rested as much as possible to keep pressure off of the ulcer.
If a foot deformity is causing too much pressure on an area of the foot or a toe, this should be corrected and this could include surgical treatment. The blood supply to the area will also be checked to ensure that it is adequate and if it is not, measures can be taken to restore an adequate blood supply.
Call us today to schedule an appointment with New York City’s best wound care center.
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An infected wound is one that has been invaded by microorganisms such as bacteria. Once a wound is infected, it can deteriorate or not heal at the rate it should.
Wound infection can become very serious, very quickly, so it is important to understand the risks, how infection occurs and what needs to be done if there is an infection. It is important to note that many surgical-related deaths are due to wound infections.
An infected wound will generally exhibit the following signs and symptoms:
· Pain or discomfort
· Pus or discharge
· Non-healing of the wound
· Redness or swelling
· Bad odor
Bacteria is the most common culprit. It can come from the environment or the patient themselves. The normal flora present on the skin is usually harmless, but when the skin is broken, bacteria can colonize in the wound causing an infection. Staphylococcus aureus is the most common bacteria found in infected wounds and things like unhygienic practices and improper wound dressing techniques can increase the risk of this bacteria entering a wound.
Proper wound care is the first thing that a doctor will address. It is critical that a wound have a proper environment so that the cells that promote healing are able to function properly. When infected, often, the dressing must be changed at least once a day, but some wounds will require more frequent changes if there is a lot of drainage. During the changing of the dressing, sterile technique should be used to prevent further infection and more microorganisms from invading the wound.
Antibiotics are commonly used and may be taken orally, administered through an IV or applied directly to the wound. It is critical that all antibiotics be taken exactly as prescribed to ensure the best results.
If you suffer from infected wounds, or any wound in general, call us today to schedule an appointment with New York City’s best wound care center.
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Skin grafts can be used to promote the healing of wounds and they help to replace skin where there no longer is any. The graft is taken from another area of the body and is placed on the wounded area, such as after a burn or another serious injury. Unlike a skin flap, a graft does not have its own blood supply and the wound bed is responsible for supplying the graft with nutrients.
Looking at the Skin Graft Procedure
An IV is started so that the doctor can provide fluids and medicine before and after the procedure. General anesthesia is used so that the patient is asleep throughout the procedure, so there is no discomfort or pain. A piece of skin is take from the donor site and this is usually an area that the clothes cover, such as the buttocks or upper thighs. The chest wall or abdominal wall are generally used for a full-thickness graft.
The donor skin is then placed over the area that is receiving the graft and staples, stitches or a surgical dressing is used to secure the graft in place. The grafted area is then dressed and the patient is given full discharge and aftercare instructions to ensure proper healing of the grafted wound.
Aftercare for a Skin Graft
After the surgery is over, it is important to ensure that the area is well-protected for at least three weeks to ensure that further trauma does not occur. A dressing is typically worn for seven to 14 days and depending on the site of the graft, patients may undergo some form of physical therapy. If a full-thickness graft is done, patients typically spend some time in the hospital to recuperate and how long will depend on the size of the graft, as well as other factors, such as overall patient health.
Possible Risk of Skin Graft Surgery
This is a surgical procedure so there are potential risks that all patients should be aware of, including:
Flap surgery involves taking a piece of skin that remains attached to the body via a vein and artery. It is placed on an injured area and can contain just skin and fatty tissue, or it can also contain muscle. This is often used for wounds that are significant, such as wounds left after a mastectomy or after a major traumatic accident.
Skin Flap Versus Skin Graft
Flaps tend to be more resilient than grafts because they come with their own blood supply. This means, that from a cosmetic standpoint, flaps usually come with better results and the texture and tone of the skin is better matched. When a deep wound needs to be filled and covered, flaps are also a better option because they have more bulk to them.
Skin Flap Wound Care
It is important for the sites to be kept clean so that the risk of infection is as low as possible. The wounds from the donor site and on the flap site must also be kept completely dry and fresh bandages should be applied after washing the area with soap and water and drying it completely.
For the first six months after flap surgery, it is important to not allow the area to to be exposed to the sun because it is critical that the skin not be burned. Lotion can be used on the area once your doctor gives you the okay to do so, because you do not want the skin to get scaly or dry.
Possible Complications of a Skin Flap
A skin flap surgery is a procedure that can come with risks, but most of these are things that most people will not experience. However, you need to be aware of them and they can include:
Adequate nutrition is important for all aspects of life, but when healing from a wound, it is even more important. What you eat has a direct relationship to how you and your wound heals and recovers. All wounds, regardless of size, are able to change how the body metabolizes nutrients. A chronic wound can result when someone does not eat properly to aid in the healing process. In addition to increasing caloric intake, there are also specific nutrients that are necessary during the recovery process.
Protein is necessary to help damaged tissues to heal, and during recovery, it is important to increase protein intake. Ideally, two to three protein servings per day will be adequate, but this must be in addition to more calories. If someone is increasing protein, but not increasing calories, the body may take that extra protein and instead of promoting healing, will turn it into energy.
Carbohydrates during the healing process will help the body to have the energy it needs so that it is not leeching energy from other critical nutrients. Adding a serving of carbohydrates to each meal will help to ensure that you are getting enough.
Dairy fats will help to promote wound healing and fatty acids are responsible for creating cell membranes. Fats that come from meat and cooking oils will also lend a hand in the healing process. Adding some cheese to a sandwich, or having a cup or yogurt for a snack are two examples of how to get more fats.
Vitamin C is an antioxidant that helps to promote collagen and strengthen the wound during the healing process. This vitamin will also increase iron absorption and help to create new blood vessels. Just one serving of a food rich in vitamin C, such as leafy greens or citrus fruits, will ensure that you get the 200 milligrams a day necessary.
This is another antioxidant that helps to control inflammation and fight off infection. It is important to not get too much of this vitamin, however, because a toxicity could be detrimental to healing. Dark green vegetables and red fruits supply this vitamin.
Zinc is well-known for helping to fight illness, so naturally, it would make sense when recovering from a wound. It helps to develop collagen and synthesize proteins. Meats are rich in this mineral, so when increasing protein, you can also increase zinc.
A superficial wound is one where only the top layer of skin is affected. The most common superficial wounds include minor abrasions, lacerations and contusions. These are generally easy to care for and require no medical intervention for most people. Understanding what these are and how to identify them is necessary to ensure the proper care.
An abrasion is commonly referred to as a scrape and it only does slight damage to the epidermis in the case of a superficial abrasion. This type of wound most commonly occurs as the result of the skin sliding against a rough surface. For example, falling off of a moving bicycle can result in a scrape when the skin hits the concrete.
Wound Care Treatment of Abrasions:
Treating this injury is easy and it simply involves removing any debris and cleaning the wound with soap and water. A topical antibiotic can be applied to the area to prevent infection and drying out of the wound. While a dressing is not necessary, it is a good idea to apply sterile gauze when a topical antibiotic is used to prevent it from rubbing off.
A superficial laceration is a minor cut or tear in the top layer of the skin. Something like a paper cut would be a good example of a superficial laceration. These wounds tend to bleed minimally and they heal fast for those in generally good health.
Wound Care Treatment of Lacerations:
The treatment is exactly the same as superficial abrasion treatment. Make sure that any debris are removed from the laceration, clean it with soap and water, apply a topical antibiotic and dress it with a sterile bandage.
A contusion, or a bruise, occurs when the capillaries located under the skin rupture as a result of trauma. For example, if you are walking through the house and hit your hip on a table, this can burst the capillaries and result in a contusion developing on the area that was hit. A superficial contusion is generally small and not very dark in color. They will be purple and as they fade, become more of a yellow color.
Wound Care Treatment of Contusions:
Treating a superficial contusion involves just keeping the area safe so that it does not get bumped again. Since the skin is not broken, there is no need for dressings or topical antibiotics.
Call us today at (212) 874-1638 to schedule an appointment with New York City’s best wound care center.
Debridement is done to remove tissue that is dying, infected or damaged. The human body is able to debride wounds that are small without any human assistance, but large wounds do require medical procedures. There are different types of debridement that can be done to keep a wound clean and promote optimal healing.
Wound debridement is one of the most important factors in healing wounds. In addition to removing devitalized tissue, debridement stimulates bleeding which starts the healing process. Bleeding brings platelets and growth factors to the wound to initiate the healing process.
The following are debridement procedures that can be done:
All of these types of wound debridement are performed differently and involve a unique procedure. Hydrotherapy debridement can be quite painful, but the other types tend to be far less uncomfortable for the patient.
Debridement can be helpful in many instances, but it is most often used for the following:
All medical procedures have risks, but complications are rare with this procedure. However, the complications that your doctor will review will include:
Certain factors can increase the risk of a patient experiencing complications and these can include:
Call us today at (212) 874-1638 to schedule an appointment with New York City’s best wound care center.
Welcome to our new Wound Care Center NYC Blog!
We are the leading wound care center in NYC providing multi-specialty treatment for chronic wounds by the most highly trained experts in the field.
We define non-healing wounds as open sores that have not gotten significantly better in the time frame that one would expect to see improvement. This, obviously, is a subjective measurement but there is a science and art to wound healing that is open to the interpretation of the clinician performing wound care.
All wounds, and all patients differ in their ability to heal. Likewise, all non-healing wounds have some underlying factor that makes them not heal. This can be their underlying cause or their current state.
Our physicians have extensive experience with wounds. It is this experience that allows them to practice the art of wound healing that includes and exceeds the science behind it.
The Weill Cornel Medical Center (PALP) Program for Limb Preservation specializes in treating patients that are at high risk for foot and leg amputations. Most of these patients suffer from Diabetes and Vascular disease.
PALP consists of a multispecialty team of expert health care providers that specialize in healing wounds. The team consists of Podiatrists, Vascular specialists and other experts that treat diabetes, peripheral vascular disease and other problems associated with wounds.
We only specialize in treatments to get wounds to heal and prevent the need for amputation.
We are the only wound care center in NYC that provides diagnostic evaluation, advanced treatments for wound care, hyperbaric oxygen therapy (HBOT), reconstructive foot surgery, traditional open and minimally invasive vascular surgery, and investigational wound care treatments such as stem cell therapy.
Our team of experts works together to get wounds to heal, improve blood flow, prevent amputation, prevent recurrence of wounds and to keep patients healthy and walking.
· Peripheral arterial disease
· Limb ischemia
· Chronic foot wounds
· Chronic lower extremity wounds
· Foot infections
· Bone infection privacy osteomyelitis)
· Diabetic foot problems
· Peripheral neuropathy and associated problems
· An appointment with a vascular surgeon and podiatrist can be made in the same visit for patients that needed.
· Additionally in the same visit patient I received vascular testing, x-rays, footwear, orthotics and wound care treatment.
· We eliminate the problems and delays and obstacles that often delays treatment and complicates wounds and these indications.
· We specialize in treating wounds of the lower extremity the patient’s that her at high risk for lower extremity amputations including those with diabetes and peripheral arterial disease.
· Our team approach with multiple specialists allows for early diagnosis in patients that are at high risk for amputation and rapid intervention to prevent amputation.
· We enable patient to participate in new clinical trials with high-tech wound care products, new cell based therapy and other experimental treatments.
· Vascular surgery
· Infectious disease
· Internal medicine
· Orthotics and prosthetics
· Noninvasive vascular testing
· Invasive vascular testing
· Plastic and reconstructive surgery
· Treatment foot infections including incision and drainage and antibiotic management.
· Specialized wound care dressings.
· Revascularization surgery for peripheral tear disease including angioplasty, atherectomy, bypass and stents.
· Hyperbaric oxygen therapy.
· Offloading of the foot including total contact casting, removable brace is on walkers, and biomechanical and pressure analysis.
· Shoe modifications including rocker-bottom shoes, custom molded insoles and extra-depth diabetic shoes.
· Reconstructive foot and ankle surgery to alleviate pressure including removal of bone spurs, removal of bony prominences, tendon lengthening and joint procedures.
· Plastic surgery for wounds including skin grafts, flaps and tissue transverse.
· Management of diabetes.
· Management of cardiovascular risks.
· Darren B. Schneider, MD
Chief, Division of Vascular and Endovascular Surgery
Director, Program for Advanced Limb Salvage (PALP)
· Harry L. Bush, Jr. MD
· Peter H. Connolly, MD
· John Karwowski, MD,
· Andrew J. Meltzer, MD
· Michael Silane, MD
· John J. Doolan, DPM, FACFAS
· Jason A. Spector, MD
· David M. Otterburn, MD
· Roger Yurt, MD
Chief, Burns, Critical Care and Trauma
Director, William Randolph Hearst Burn Center
· James Gallagher, MD
· Palmer Q. Bessey, MD
· Wanda See, NP
· Weill Cornell Internal Medicine Associates (CIMA)
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