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March 26, 2008 > Health & Wellness Seminar: Treating Chronic and Infected Wounds

Health & Wellness Seminar: Treating Chronic and Infected Wounds

Most of the time, your body's natural defenses are sufficient to help heal a wound. As long as the wound is cleaned and covered with a sterile dressing, the body produces new cells and blood vessels to make the wounded area "as good as new." On occasion, though, a wound will become infected or another health condition will prevent healing and the wound will become chronic.

"There are many possible reasons why a wound fails to heal properly," says plastic and reconstructive surgeon Dr. Prasad Kilaru, Medical Director of the Outpatient Wound Care Clinic at Washington Hospital. "When we're dealing with a chronic wound - one that has not healed within six weeks - we first have to determine why the wound isn't healing before we can provide the proper treatment to promote faster healing and avoid further complications."

To help people understand more about dealing with chronic and infected wounds, Dr. Kilaru and infectious disease specialist Dr. Dianne Martin, who serves as a consultant to the Outpatient Wound Care Clinic, will offer a special Health & Wellness Seminar on wound care on Tuesday, April 8 from 1 to 3 p.m. The seminar will be held at the Conference Center adjacent to the Nakamura Clinic at 33077 Alvarado-Niles Road in Union City. For more information about the seminar, or to register to attend, visit or call (800) 963-7070.

At the seminar, Dr. Kilaru will explain various factors that can affect wound healing, including poor nutrition, smoking, diabetes and poor blood circulation.

"In terms of nutrition, it's important to look at the patient's protein levels since protein is essential to the wound-healing process," he explains. "It's also important to have an adequate calorie intake. Various vitamins and minerals are important to healing, too.

"Smoking reduces blood circulation, which slows the transport of oxygen to the wounded body tissues," he adds. "Carcinogens and other elements in tobacco smoke also deter healing."

Diabetes can also impede wound healing. "About half of the patients at the clinic have diabetes," Dr. Kilaru says. "We work closely with these patients to monitor and control their diabetes by providing dietary recommendations and various exercises to increase their mobility and improve blood circulation."

The seminar also will cover prevention and treatment of wound infections, which can kill off the "healing cells" in addition to causing decay of infected tissues.

"To prevent infections, it's important to keep wounds clean and cover them with sterile dressings to create a warm, moist environment that is conducive to healing," Dr. Kilaru notes.

"Treatment of wound infections depends on the type of infection," he says. "We take a culture of the wound to ensure that we are using the right antibiotic for that specific infection. In some cases, the patient might not need an oral antibiotic - a topical antibiotic applied to the skin will suffice - but we won't know that without taking the culture."

An antibiotic that is suitable for treating a patient with diabetes may not be appropriate for a patient with poor circulation. A polymicrobial infection that involves several different bacteria would require yet another type of antibiotic.

"We also need to determine if the infection is due to a fungus, rather than a bacteria," Dr. Kilaru says. "Fungal infections are more common in people with compromised immune systems, which can include people with diabetes or people on steroid medications or long-term antibiotic treatments."

MRSA (Methicillin-resistant Staphylococcus aureas) infections are also a concern. MRSA is a type of drug-resistant bacterial infection that is becoming more widespread in the community at large, with the rate of infection rising rapidly due to the overuse of antibiotics.

"There's a fine line in determining when and what types of antibiotics to use," Dr. Kilaru says. "If we don't get people on the proper antibiotic, they may develop a more resistant infection. That's why we take a targeted approach in matching antibiotics to the patient's wound culture, rather than a scattershot approach of simply giving a broad-spectrum antibiotic for all wound infections."

Opened in March 2005, the Outpatient Wound Care Clinic provides advanced wound care treatment technologies tailored to the specific needs of each patient. In addition to Dr. Kilaru and Dr. Martin, the multi-disciplinary clinic team includes:
* Podiatrists Dr. Divyang Patel, Dr. Joshua VanGompel and Dr. Bita Mostaghimi
* Vascular surgeons Dr. John Mehigan and Dr. Rakesh Safaya
* Infectious disease specialist consultants Dr. Eva Quiroz and Dr. Muni Barash
* Nursing specialists with specific training in wound treatment
* Access to physical therapists, dietitians, diabetes educators and pain management specialists

The clinic staff coordinates patients' care with their primary care doctors to provide continuity of care, but a physician referral is not required for making an appointment for an evaluation. The clinic is located at 1900 Mowry Avenue in Fremont, adjacent to Washington Hospital. Appointments are available on Mondays, Wednesdays, Thursdays and Fridays. For more information, or to schedule an appointment, call (510) 608-3290.

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