Effective, Cost-Effective Wound Care

Julian Whitaker, MD

Cecil is a 68-year-old with a decades-long history of diabetes and diabetic ulcers on his feet. In an attempt to curb infection, the toes on his right foot had been amputated. However, despite intensive, expensive wound care, the ulcers weren’t healing, and Cecil was facing amputation. So he came to the Whitaker Wellness Institute as a last resort.

After four days of treatment, the open, oozing sores on Cecil’s foot began to close. Within a week, he was well on his way to recovery. And today, his wounds are completely healed.

How did we accomplish in a matter of days what Cecil’s doctors failed to achieve in months? With two remarkable therapies we routinely use at the clinic—one that is underused by conventional medicine and another that is completely ignored.

Hyperbaric Oxygen Therapy

Cecil was immediately treated with hyperbaric oxygen therapy (HBOT). HBOT is an office-based therapy administered in a chamber that is slowly pressurized while patients breathe 100 percent oxygen. Unfortunately, such chambers—and physicians who know about HBOT—are few and far between. Despite solid scientific evidence showing that it improves wound healing and reduces risk of major amputations, HBOT, like sugar dressings, isn’t even on the radar of most doctors. A 2010 survey of Canadian physicians revealed that more than 90 percent had little or no knowledge of the therapy, and I have no reason to believe that the situation is any better in the United States.

In my opinion, this is downright criminal. HBOT should be offered to all patients with any kind of wound. Because concentrated oxygen creates an inhospitable environment for most types of bacteria, it prevents the spread of infection and speeds recovery from burns, bites, post-surgical incisions, bedsores, and sports injuries of any kind. But for wounds related to diabetes, neuropathy, or peripheral vascular disease—conditions that damage the arteries and veins and impair circulation—HBOT should be required.

The primary cause of these lesions is ischemia, or insufficient blood supply. If a healthy person stubs his toe or gets a blister on his foot, it heals up in no time. However, if the blood vessels that deliver oxygen, nutrients, and infection-fighting immune cells to the injury site are compromised, healing becomes next to impossible. Lesions get larger and deeper, and after a time, the surrounding tissues shrink, turn black, and take on a “mummified” appearance. At this point, you have a real problem.

When oxygen is inhaled under pressure, it dissolves in all of the body’s fluids, so it can easily be delivered—even to areas with inadequate blood flow. HBOT also stimulates angiogenesis (the growth of new blood vessels), the production of growth factors, and the mobilization of stem cells. Together, these mechanisms have a dramatic impact on ischemic wounds. Studies show that HBOT increases the “limb salvage rate” (avoidance of amputation) from 61 percent with conventional treatment to 89 percent!

Sugar Dressings Outperform Conventional Wound Care

We also covered Cecil’s wounds with sugar and bandaged them up. As you may know, conventional wound care involves debridement, or removal of dead and infected tissue to prevent infection and support healing. It’s a painful experience and requires frequent visits to a clinic or wound care center. With sugar dressings, however, this practice is completely unnecessary because sugar stimulates natural debridement.

Antibiotics are also often given. Although these drugs are appropriate for bone or systemic infections, they are unwarranted for superficial wounds. No antibiotic comes close to sugar for local infection control. Sugar dissolves in the fluid of an open wound and creates an osmotic environment in which no bacteria can survive. Like a freshwater goldfish thrown in the Great Salt Lake, bacteria and fungi quickly die in this concentrated, hyperosmotic environment. Furthermore, there’s no danger whatsoever of drug resistance with sugar.

As sugar draws fluid from deep within the wound, it reduces edema. This stimulates the growth of granulation tissue to fill in the wound and the formation of new skin cells to cover and repair the lesion. The end result is rapid, consistent, and predictable healing of any type of open wound with minimal scarring.

Lots of Dollars, Little Sense

Health care costs are a hot topic these days, and wound care expenditures must be part of the dialog. Every year in this country, more than 1.3 million patients develop diabetic ulcers, and up to a quarter of them will eventually require an amputation. We spend more than $5 billion treating these patients, plus another $1 billion on related amputations.

The costs don’t end there. Prosthetic limbs can range anywhere from a few thousand to tens of thousands of dollars. Furthermore, these limbs wear out and must be replaced every few years. And then there’s the matter of physical therapy, home health care, and follow-up visits, all of which add up quickly. An amputation costs eight times more than a course of HBOT, and compared to sugar—well, there’s just no comparison. You can treat a wound with sugar for months for only a few bucks.

Cynical as this may seem, I contend that one reason these proven therapies have not been adopted is because of their low cost. Just think of the financial impact they would have. Hospital stays would be dramatically reduced or not required at all, wound care centers would empty out, and “bottom lines” would hit bottom.

Costs aside, the real reason I’m telling you about these therapies is because they work better. Had Cecil continued with his conventional care, there is no doubt he would have had an amputation by now. He would likely be in physical therapy, getting used to his prosthesis, and learning to walk again. And for many patients, an amputation is only the beginning of more problems. Loss of the opposite limb is very common, and post-amputation death rates run as high as 50 percent after three years and 70 percent after five.

Instead, Cecil is walking around on his own two feet. Thanks to the lifestyle and supplement program he started at the clinic and has continued at home, his blood sugars are lower and, along with them, his risk of recurrent infection. Although he’s not out of the woods, he is certainly approaching the clearing.

Recommendation

• For more information on receiving hyperbaric oxygen therapy and care for any type of non-healing wounds at the Whitaker Wellness Institute, call (866) 944-8253.

References

• Evans W, et al. Hyperbaric oxygen therapy and diabetic foot ulcers. Knowledge and attitudes of Canadian primary care physicians. Can Fam Physician. 2010 May;56(5):444–452.
• Heyneman CA, et al. Using hyperbaric oxygen to treat diabetic foot ulcers: safety and effectiveness. Critical Care Nurse. 2002;22:52–60.
• Roeckl-Wiedmann I, et al. Systematic review of hyperbaric oxygen in the management of chronic wounds. Br J Surg. 2005 Jan;92(1):24–32.

Modified from Health & Healing with permission from Healthy Directions, LLC. Photocopying, reproduction, or quotation strictly prohibited without written permission from the publisher. To subscribe to Health & Healing, click here.