How a new and improved Wound Care Center is saving patients from losing limbs

It looked like a 1970s medical office. That’s how Nadelyn Backer described the conditions of the Comprehensive Wound Care & Hyperbaric Center at Long Island Jewish Valley Stream hospital.

But that all changed last week. A sliding reception window on a pale brown semi-circular desk now has a sleek, windowless replacement. The refurbished space freed up room for a long-requested waiting area. Backer, the center’s program director, noted that it sees many elderly patients, some of them using walkers, who need a place to sit.

The newly renovated center now has three exam rooms staffed by four surgeons, and its team of nurses and technicians has been sought after by patients near and far for its unique outpatient program. For years, the program’s physicians have focused on treating patients plagued by wounds that don’t seem to heal — or, when healed, keep coming back. Often, they fester on the lower legs, feet and toes.

People can live for decades with chronic sores or painful skin ulcers, but eventually, without treatment, they become susceptible to a host of mobility and more general health issues, including reduced blood circulation and severe infection. In some cases, an unhealed wound may necessitate amputation.

“We want to do everything to treat and heal the wound to prevent patients from losing toes, feet or legs,” said Dr. Devendra Brahmbhatt, a vascular surgeon and the center’s medical director. “So perhaps a better name for this wound care center is an amputation-prevention program or the limb-saving program.”

The wound care center has undergone a loss — and a transformation — of its own. Northwell Health, Long Island Jewish Valley Stream’s parent company, acquired the center after sharing managerial custody with Healogics, the nation’s largest wound management company.

That is good news, and a “completely fresh start,” according to Backer, who said that merging the facility with the larger health system makes it part of Northwell’s expansive service line and streamlines the center’s chain of command.

“We had two different management entities to report to,” Backer explained, which caused redundancies in regulation and hospital protocol. That’s gone now.

And the biggest beneficiaries of this consolidation in care, Backer added, are the patients who will have access to faster, better-coordinated health services. “Since our separation from Long Island Jewish Valley Stream , our patient volumes have increased, and our patients’ satisfaction scores have increased,” she said, noting that the hospital averages 350 patients per month.

“There is a great need for wound care healing in the community,” Brahmbhatt said. Patients are often kept in the dark about unhealed wounds despite regular doctor’s visits. Others are aware, but unsure of how or where to seek comprehensive treatment, often resorting to expensive out-of-hospital trips to specialists.

“You don’t have to go to Manhattan, or anywhere else for that matter,” Brahmbhatt said. “The center has state-of-the-art healing technology and a team of physicians for every wound care need right in your own backyard.”

In cases of severe wounds, physicians at the hospital can use a novel intervention known as hyperbaric oxygen treatment, meant to boost the body’s ability to heal itself.

“We breathe in air from Earth’s atmosphere, which is 21 percent oxygen, but in hyperbaric oxygen treatment, the patient breathes in 100 percent oxygen at greater-than-normal pressure,” Brahmbhatt explained. This helps restore oxygen-starved wounds, and enhances the body’s regeneration with a roughly 80 percent success rate.

A common theme among many patients, Brahmbhatt said, is a diagnosis of diabetes, a chronic condition that affects the body’s ability to manage blood sugar. Diabetics who do not manage their condition well are more apt to suffer from slow-healing wounds, because persistently high blood sugar levels disrupt blood circulation, dampening the body’s normal wound-healing process. These patients also tend to be older.

It’s difficult for older patients who are battling chronic conditions to stick to a strict wound-healing regimen without ongoing support, Brahmbhatt reasoned.

“The challenge is to get the patient to follow their wound-healing process according to our instructions,” he said. “Sometimes there are obstacles to securing the sort of medical supplies they need because of insurance issues, which Northwell helps to address.

“We follow the patients periodically, because the wounds can change very quickly,” Brahmbhatt added. “We provide transportation and accessible accommodations at our center. And we follow our model of comprehensive care until the wound is healed. That is our challenge.”

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