Chronic wounds usually involve other related medical conditions that work to impair the healing process. As part of his integrated approach to wound healing, Dr. Brem works closely with other specialists to identify and address any such medical conditions, including the following:
Diabetes. Working with a diabetes specialist to manage the patient's blood glucose levels helps accelerate the healing process and prevent new diabetic wounds from developing.
Neuropathy. Diabetes-related nerve damage in the legs and feet is a key contributor to diabetic foot ulcers. A surgical technique called nerve decompression can help this condition.
Impaired peripheral blood flow. Reduced blood circulation in the legs due to arterial plaque is a major reason why leg and foot wounds fail to heal. In these cases, bypass surgery or angioplasty to restore blood flow to the affected area can often help the healing process.
Venous insufficiency. This condition, in which blood becomes “backed up” in the veins, is associated with varicose veins and can also cause venous ulcers to form. Once a venous ulcer has begun healing, working to resolve the underlying problems with blood flow through the veins can help prevent a recurrence.
Cardiovascular disease. Conditions such as atherosclerosis, hypertension or arrhythmia can often impair blood flow to a patient's wound, impairing the healing process. In these cases, Dr. Brem and his team work closely with the patient’s cardiologist to treat the underlying condition.
Kidney disease. Impaired kidney function, a common complication of diabetes, can also iimpeded wound healing. If tests of a patient’s kidney function reveal abnormalities, Dr. Brem will work closely with a nephrologist (kidney specialist) to address the condition.
Skin trauma. For patients with diabetic foot ulcers or pressure ulcers (also known as bed sores), taking pressure off the affected skin area is an essential step in enabling the wound to heal and preventing new wounds from forming.
Nutritional issues. Proper nutrition is key to the wound healing process. Dr. Brem and his team evaluate each patient’s nutritional status and provide nutritional supplementation to address any deficiencies that are identified.