Wound Care

Several types of wounds can occur across the lifespan. These can be acute (lasting over several weeks) or chronic (lasting over months). Chronic wounds that don’t heal on their own need specialty wound care.

Wounds go through several stages to mend on their own. Initially blood will clot over the wound, and the body will use its defenses to clean the wound to protect the site from germs. The defensive/inflammatory phase, which lasts between four and six days, comes next. During this phase, bacteria is destroyed, and any debris is removed so new tissue can grow at the wound site.

The third phase, the proliferative phase, features three distinct stages: 1) filling the wound; 2) contraction of the wound edges; and 3) covering the wound (epithelialization). Blood vessels bring oxygen-rich blood to the area to promote healing, and damaged tissue regrows.

During the last phase, called maturation, the injured area regrows skin, remodels and increases tissue strength.

The healing process normally takes a few weeks, but many factors — including infection, nutrition, diabetes, poor circulation, smoking and some medications — can delay the process.

If a wound has failed to heal after four weeks, it may be time to seek help from the Comprehensive Wound Center at Central Maine Medical Center or one of its satellite locations at Rumford Hospital or Bridgton Hospital. Our wound centers provide specialized care and treatment not typically offered at a primary care office. This care is provided by wound  and ostomy certified nurse practitioners  and nurses.

Wound Care Services Available From Central Maine Healthcare

Central Maine Healthcare wound care experts offer evaluation and treatment for all types of wounds, including those related to surgery, trauma or diabetes, as well as venous and arterial wounds. We also provide pre- and post-surgical care, education, and support to patients undergoing ostomy surgery.

Central Maine Healthcare’s team of certified wound and ostomy nurses and nurse practitioners will assess your wound and develop an individual treatment plan taking into account all factors that may be impacting your healing. Depending on the type of therapy needed, you may need to visit the clinic on a weekly basis until your condition improves. Your provider will give you guidance for at-home wound care in between visits and will collaborate with home health services if needed.

Along with physical aspects of care, Central Maine Healthcare’s wound care team members provide emotional and social support. A serious, non-healing wound can be a life-altering event, and we offer compassion while helping patients manage their injury or health condition

Why Choose Central Maine Healthcare for Wound Care?

The Comprehensive Wound Center at Central Maine Medical Center provides patients with advanced wound treatment close to home. With satellite clinics in Bridgton and Rumford, there is no need to travel far to receive comprehensive and compassionate care for wounds or ostomies.

Our team includes nurses and advanced practice nurses who have Wound, Ostomy and Continence certification. With a combined 20+ years of wound and ostomy experience, our team is skilled at helping you heal.

When your care needs the collaboration of other medical specialists, our relationship with other specialty healthcare providers allows us to develop a comprehensive treatment plan. Our clinic experts work together with other specialists to offer patients a comprehensive treatment plan. We often collaborate during your appointment with providers from other specialties, such as infectious disease; oncology; vascular, general and plastic surgery; and physical and occupational therapy services. This collaborative approach can help you achieve your treatment goals.

Wounds We Treat

Non-healing wounds often require intervention from a wound care specialist. At Central Maine Healthcare’s Comprehensive Wound Center, based at Central Maine Medical Center with satellite clinics at Rumford Hospital and Bridgton Hospital, a team of experts can identify the cause of non-healing wounds and provide advanced treatments and therapies for repair.

Types of Wounds

The experts at the Comprehensive Wound Center offer diagnosis and treatment for a wide variety of wounds, including:

• Arterial (ischemic) ulcers. An arterial ulcer occurs when there is inadequate blood flow to the legs. The most common cause of arterial ulcers is atherosclerosis, which causes the arteries to become clogged and prevents healthy blood flow through the body. When blood cannot reach the feet or legs, tissue damage occurs and may cause an open wound on the lower extremities. The sore is slow to mend due to the lack of blood flow necessary for healing. Adults with diabetes, high cholesterol and high blood pressure and those who smoke and are older are most at risk for developing arterial ulcers.
• Neuropathic ulcers. A neuropathic ulcer occurs as a result of decreased sensation. One of the most common causes is diabetes, which can cause nerve damage to the feet that allows wounds to go unnoticed. In addition, high blood sugar levels can alter the body’s ability to fight an infection and heal the wound. Neuropathic ulcers can take months to heal if not properly treated.
• Venous ulcers. These open sores occur on the legs as a result of venous insufficiency. Venous insufficiency causes leg swelling that can result in tissue damage, because the veins cannot properly send blood from the legs back up to the heart. Adults with a history of blood clots, multiple pregnancies, prolonged standing/inactivity, IV drug use and conditions that cause clot formation are most at risk of developing venous insufficiency and venous ulcers.

Untreated wounds can cause serious problems, including infection, pain and, in some cases, limb loss. Experts at the Comprehensive Wound Center provide a variety of specialty treatments and therapies for patients with non-healing wounds.

Our clinic experts work together with other specialists to offer patients a comprehensive treatment plan. We often collaborate during your appointment with providers from other specialties, such as infectious disease; oncology; vascular, general and plastic surgery; and physical and occupational therapy services. We provide both inpatient and outpatient care and consultation.

In addition to treating wounds, our wound specialists also provide care for:

• Lymphedema occurs when lymph — a fluid that helps your body fight infection — builds up under the skin. This causes swelling, usually in the arms and legs. Patients who have received cancer surgery or radiation therapy often experience lymphedema because of damage or removal of the lymph nodes. It can also result from infections or injury.
• An ostomy is a surgically created opening in the abdomen that connects an internal organ with the surface of the skin.  The usual purpose of an ostomy is to allow the elimination of body waste through this artificial opening.  Typically, this connection is made to the bowel but can also be made for bladder issues as well. The opening on the abdomen is fit with a pouch that sticks to the body and collects waste material. Patients with colon, rectal or bladder cancer; trauma or injury; and bowel disorders such as Crohns’ disease, ulcerative colitis, diverticulitis or fecal incontinence may need an ostomy.

Treatments and Specialties

Wounds left untreated can cause serious problems. Chronic non-healing wounds can result in scarring, infection, pain or, in some cases, limb loss. Experts at Central Maine Healthcare’s Comprehensive Wound Center, based at Central Maine Medical Center with satellite clinics at Rumford Hospital and Bridgton Hospital, provide a variety of specialty treatments and advanced therapies for patients with non-healing wounds and other conditions.

Our clinic experts work together with other specialists to offer patients a comprehensive treatment plan. We often collaborate with providers including those from infectious disease; oncology; vascular, general and plastic surgery; and physical and occupational therapy services.

We provide both inpatient and outpatient care and consultation. Hospitalized patients with wound care needs will see an expert from our wound care team.

Some of the treatments offered include:

Debridement

Debridement removes dead or inflamed tissue from a wound so it can heal. For painful wounds, a local anesthetic is used to numb the area. Your provider will use a series of tools to remove any dead tissue.

The Comprehensive Wound Care Center also offers ultrasonic mist therapy as a less invasive option for debridement. This procedure uses ultrasound delivered by a fine mist to break down damaged tissue. The wound is then cleaned and dressings are applied.

Studies have shown ultrasound mist therapy helps decrease pain and promote healing to a wound.

Compression Therapy

Management of edema — swelling — is essential to wound healing. Compression therapy uses compression stockings or bandages to help a wound heal faster by applying gentle pressure that decreases swelling. Patients with venous ulcers and lymphedema often benefit from compression therapy.

Negative Pressure Wound Therapy

Negative pressure wound therapy, also called vacuum-assisted closure therapy, is helpful for acute or chronic wounds. When artificial implants, burns, exposed bone, infections or poor circulation impact healing, negative pressure wound therapy can offer solutions.

During this therapy, the wound is covered in a dressing that is attached to a pump. The pump creates a vacuum, which helps wounds heal by controlling drainage, increasing blood flow to the area, keeping the wound moist and increasing collagen formation.

Studies show this therapy promotes quicker healing for wounds.

Total Contact Casting

A total contact cast is the gold standard for treatment of diabetic foot ulcers. The ulcer is covered with soft foam, and then bandages are wrapped around the foot before it is casted in a non-removable cast. The contoured cast helps distribute weight on the foot to encourage offloading, or limiting the use of the foot with the ulcer.

A total contact cast could help your ulcer heal much faster.