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The discharge report also includes statements about how the patient met the original goals of the treatment plan and any ongoing follow-up care. The Facets of Wound Care Treatments at the Center for Wound Healing, for ease of discussion, are described in two categories — tradi- tional or advanced wound care. The traditional care of wounds includes, but is not limited to, debride- ment (sharp and nonselective) and wound dressing and coverage (algi- nates, composites, collagens, foams, hydrocolloids, hydrogels, transparent films, wound fillers or contact lay- ers). The wound assessment dictates which dressing/coverage will promote optimal healing. Advanced wound care may include the utilization of a bioengineered skin substitute/wound matrix such as Apligraf, Dermagraft or OASIS. The laboratory-manufactured products are generally used to stimulate heal- ing in ulcers that have not achieved 50% closure around the six-week timeline of standard/tradit ional aggressive therapy. Another frequently used modal- ity is a vacuum-assisted closure or negative-pressure wound therapy. This treatment assists in wound closure by using localized negative pressure to draw the edges of a wound to the center. The negative pressure therapy is applied to a special dressing positioned in the wound cavity or over a flap/graft. This pressure-distributing wound packing helps remove fluids from the wound and stimulate the growth of healthy granulation tissues. Negative pressure applies noncompressive mechanical forces to the tissue that allow arterioles to dilate and increase blood flow. Hyperbaric oxygen therapy, another frequent ly used modality, which was traditionally linked to treating carbon monoxide poisoning and the Bends until the 1990s, incorporates atmospheric pressure to heal a wound at the tissue level. As patients' entire bodies are exposed to 100% oxygen at an increased pressure, the therapy serves as a bactericide, clears inert gas from the bloodstream with a higher concentration of dissolved oxygen that is then metabolized, and promotes the growth of collagen matrix in the wound. This adjunctive modality is effective in healing wounds resulting from, but not limited to, diabetic complications, chronic refractory Julie Wagner, R.N., and Scott Francis, M.S., P.T., consult on a case. much to do, and at times, it becomes overwhelming "Patients have so convenient as possible for them to get concerns and make it as easy and for them. We try to minimize their comprehensive foot care, nutritional counseling and the health services they need, such as physical therapy, are working toward making our center as comprehensive as possible with a Home Care. In our fragmented health care system, we services provided by St. Francis receive all their care under one roof." physical layout that allows patients to FACS, wound care specialist and vascular and general surgeon, Medical Director of the Center — Jayesh R. Modi, M.D., RVT, for Wound Healing, and Director of the Department of Surgery at Saint Francis Hospital MDNEWS.COM ■ MD NEWS Mid Hudson | 9