To manage the rising numbers of persistent and stalled wounds, adoption of advanced therapies and a partnership between healthcare providers and patients is essential.
For most people, minor wounds heal in a few weeks and can be forgotten. But for many, wound healing stalls: According to a study of Medicare beneficiaries, approximately 8.2 million people had at least one type of wound or wound-related infection in 2018 alone. The costs of treating and managing these wounds are estimated at $28.1 billion.
Older adults are more prone to wound healing failure, and chronic conditions like diabetes or poor leg circulation can lead to foot or leg sores or ulcers — and these wounds are not always easy to treat.
“Helping patients attain closure of their chronic wounds can sometimes be very challenging, especially in those with multiple comorbidities,” explained George J. Koullias, M.D., Ph.D., director of the Center for Advanced Wound Healing and Hyperbaric Medicine at Stony Brook Southampton Hospital, in a case presentation for Organogenesis.
These wounds often have an emotional and mental impact on patients. “They’re often shamed and prevented from going to work,” said Vickie R. Driver, D.P.M., in an interview with Access Health. “It’s often thought that they created this problem themselves.”
Studies reveal that people suffering from venous leg ulcers or diabetic foot ulcers report not just significant pain, but also impaired mobility, depression, other mental health problems, and significant missed work. Patients suffering from diabetic foot ulcers also face the threat of amputation — 85% of all lower limb amputations in diabetic patients are preceded by a foot ulcer (Journal of Clinical Orthopaedics and Trauma, 2021).
Wound management options for stalled wounds have increased, most notably with innovation to processing of placental tissue, which has been utilized for many years in a dehydrated form as a covering for wounds to support an environment for healing.
Recent improvements in the processing and preservation of placental tissue, such as hypothermic preservation, have enabled fresh wound care solutions that retain placental tissue elements closest to their native form. These new fresh processing technologies provide additional options to existing, proven, non-placental, FDA-approved living cell regenerative solutions.
“When I started in this field, the idea that we could develop products that help the body regenerate its own healthy tissue to heal wounds might have sounded like science fiction to many,” said Patrick Bilbo, chief operating officer of Organogenesis, which specializes in regenerative treatment solutions. “Today, scientific advances in the field of regenerative medicine, including the processing of living cells and native placental tissue, have made it a reality.”
But wound treatment products are only half the story. Wound care often leads to a close relationship between healthcare providers and patients due to the frequency of appointments required, and doctors must widen their focus beyond the wound itself to address the systemic factors behind persistent wounds.
Attaining patient compliance throughout the course of their treatment is a matter of communication, partnership, and education. “It is their foot or their leg,” John C. Lantis, M.D., chief of Vascular and Endovascular Surgery at Mount Sinai West, told Access Health. “And they’re going to have to do what I asked them to do. And sometimes it can be very discouraging for the patient, it can take a long time.”
Dr. Lantis added that while the wound may be the physician’s focus, they must keep in mind the human factor when providing care.
“It’s important to be honest,” he said, “but it’s also important to be supportive of the process that the patient is going through — this road that they’re going through to healing, and explaining to them how they’re also going to stay healed.”