Veins, trains and automobiles
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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
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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
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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
C1
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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
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Causes of venous (veins) ulcersCauses of venous (veins) ulcers
Hemosiderin staining
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Lower leg
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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
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We want to avoid this!We want to avoid this!
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Lower leg
Ankle
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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
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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
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PART 3: Traumatic woundsPART 3: Traumatic wounds
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Traumatic woundsTraumatic wounds
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Ankle
Shin
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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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