Veins, trains and automobiles
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Via Christi 50+ presentation on vein treatments by Marilee McBoyle, medical director of Via Christi Wound Healing and Hyperbaric Therapy
Veins, trains and automobiles
- 1. Via Christi 50+ Lunch & LearnVia Christi 50+ Lunch & Learn Veins, trains and automobilesVeins, trains and automobiles Marilee McBoyle, MD, FACS Medical Director Via Christi Wound Healing and Hyperbaric Therapy1
- 2. 2 Todays discussionTodays discussion PART 1: Veins legs and ankles PART 2: Diabetes feet PART 3: Trauma legs PART 4: Hyperbaric oxygen therapy
- 3. 3 But firstBut first A little bit about Via Christi Wound Healing & Hyperbaric Therapy 848 N. St. Francis, on the Via Christi Hospital St. Francis campus
- 4. Via ChristiVia Christi Wound Healing & Hyperbaric TherapyWound Healing & Hyperbaric Therapy Our staff 4
- 5. 5 Via ChristiVia Christi Wound Healing & Hyperbaric TherapyWound Healing & Hyperbaric Therapy Our facility
- 6. 6 PART 1: Venous (vein) ulcersPART 1: Venous (vein) ulcers Lower leg discomfort, swelling and ulcer development Causes Prevention Treatment
- 7. 7 Interesting factsInteresting facts Venous (vein) ulcers are the most frequent cause of leg ulcers Leg ulcers are slow to heal and fast to recur Chronic vein issues affect 1/3 of the adult population
- 8. 8 PART 1: CausesPART 1: Causes Stasis (blood pooling) Insufficiency Varicose veins
- 9. Venous (vein) ulcersVenous (vein) ulcers Varicose veins 9
- 10. CEAP scale for varicose veinsCEAP scale for varicose veins 10 C2 C3 C4 C5-6 Swelling V. veins Skin Changes Ulcers C1
- 11. Causes of venous (vein) ulcersCauses of venous (vein) ulcers Malfunctioning valves Blood pools Hemosiderin staining 11
- 12. Causes of venous (vein) ulcersCauses of venous (vein) ulcers 12 Malfunctioning valves
- 13. Causes of venous (veins) ulcersCauses of venous (veins) ulcers Hemosiderin staining 13 Lower leg
- 14. Prevention of venous (vein) ulcersPrevention of venous (vein) ulcers Muscle calf pump Compression hose Avoid long periods of standing 14
- 15. Treatment of venous (vein) ulcersTreatment of venous (vein) ulcers Debridement Compression Skin substitutes Minimally invasive procedures 15
- 16. Treatment of venous (vein) ulcersTreatment of venous (vein) ulcers Debridement 16
- 17. Treatment of venous (vein) ulcersTreatment of venous (vein) ulcers Compression: 2-layer or 4-layer wraps 17
- 18. Treatment of venous (vein) ulcersTreatment of venous (vein) ulcers Skin substitutes 18 Ankle: Before Ankle: After
- 19. We want to avoid this!We want to avoid this! 19 Lower leg Ankle
- 20. Part 2: Diabetic UlcersPart 2: Diabetic Ulcers CAUTION: 40-70% of all lower extremity amputations are related to diabetes. 85% of diabetic-related amputations are preceded by a diabetic foot ulcer. 20
- 21. PART 2: Diabetic ulcers, causesPART 2: Diabetic ulcers, causes Injury to blood vessels Neuropathic (cant feel your feet) Charcot foot 21
- 22. Causes of diabetic ulcerCauses of diabetic ulcer Neuropathic (cant feel your feet) 22
- 23. Causes of diabetic ulcersCauses of diabetic ulcers Charcot foot 23
- 24. Prevention of diabetic ulcersPrevention of diabetic ulcers Blood sugar control / Hb A1C Correct shoes Checking feet every day (Including the sides and bottom of feet, and in between the toes) 24
- 25. Treatment of diabetic ulcersTreatment of diabetic ulcers Debridement Culture Blood sugar control Off-loading 25
- 26. Treatment of diabetic ulcersTreatment of diabetic ulcers Debridement 26 Bottom of foot: Before Bottom of foot: After
- 27. Treatment of diabetic ulcersTreatment of diabetic ulcers Diabetic education for blood sugar control 27
- 28. Treatment of diabetic ulcersTreatment of diabetic ulcers Off-loading 28 Bottom of foot Lower leg cast
- 29. PART 3: Traumatic woundsPART 3: Traumatic wounds 29
- 31. PART 4:PART 4: Hyperbaric Oxygen (HBO) therapyHyperbaric Oxygen (HBO) therapy 31
- 32. What is Hyperbaric Oxygen therapy?What is Hyperbaric Oxygen therapy? 100 percent oxygen given with increased pressure 32
- 33. Who is a candidate for HBO?Who is a candidate for HBO? Most frequent indications Deep diabetic foot ulcers Radiation induced soft tissue injury Chronic refractory Osteomyelitis 33
- 34. What to expect with HBOWhat to expect with HBO Hyperbaric oxygen therapy treatments take about two hours You may feel pressure in your ears, similar to traveling on a plane Glass windows are built into the hyperbaric chamber, so you can watch TV or a movie In case of claustrophobia, medication can be prescribed Treatment schedules vary, based on your progress 34
- 35. Celebrating wound healingCelebrating wound healing Let the rest of your life be the best of your life 35
- 36. Summary and questionsSummary and questions Marilee McBoyle, MD, FACS Medical Director Via Christi Wound Healing and Hyperbaric Therapy 848 N. St. Francis, Suite 1900 Wichita, KS 67214 316.268.5881 viachristi.org/wound 36
Editor's Notes
- #2: Total prep time: 2 hrs (as of 6/28/14)