Local Hospital Provides Exceptional Care for Difficult-to-Manage Conditions
Wednesday, November 10, 2010
Bariatric surgery and wound care and hyperbaric medicine are two specialty services providing patients suffering with chronic conditions the opportunity to greatly improve their quality of life. At Wellington Regional Medical Center — a Joint Commission-accredited hospital in Wellington, FL — patients benefit from high-quality medical care geared toward treating both obesity and nonhealing, chronic wounds.
Photo: The bariatric team. Photos © John Stillman
According to the Centers for Disease Control and Prevention, 34% of American adults are considered obese.
“Patients with morbid obesity often suffer from comorbid conditions, which range from diabetes to hypertension, sleep apnea and arthritis,” says Paul Wizman, M.D., FASMBS, Medical Director of the Wellington Surgical Weight Reduction Center. “These conditions are directly related to the weight of the patient, so by helping patients lose excess weight, resolution of these comorbidities can often be achieved.”
For morbidly obese patients, bariatric surgery coupled with educational and supportive services provides the best chance of weight reduction and disease resolution. At Wellington Regional Medical Center, three bariatric surgical services — Roux-en-Y gastric bypass, vertical sleeve gastrectomy and adjustable gastric banding using the REALIZE band — are available. All procedures are performed laparoscopically, which allow patients to undergo a less-invasive surgery and experience a shorter recovery period.
Roux-en-Y gastric bypass involves surgically restricting the size of a patient’s stomach, limiting food consumption. During this procedure, a portion of the small intestine is attached to the resected stomach, bypassing both the duodenum and a small portion of the jejunum, which prevents the absorption of calories and nutrients. After two years, 77% of patients report excess weight reduction, and 95% of patients report their quality of life greatly improved within the first year following surgery.
Adjustable gastric banding using the REALIZE band is the only weight loss procedure that is fully reversible. Using the REALIZE band, surgeons are able to restrict the size of a patient’s stomach by adjusting the tightness of the band with a port that is placed just beneath the patient’s skin. After one year, 40% of patients report excess weight loss.
Vertical sleeve gastrectomy is the newest weight loss procedure available. It requires surgical restriction of the size of the stomach; however, it does not utilize the malabsorptive component of the Roux-en-Y gastric bypass. Patients are expected to lose about 30% to 50% of their excess weight within the first year following surgery.
By attending an informational seminar, held once each month at the Wellington Surgical Weight Reduction Center, patients learn about these options, so they can be fully informed to help in the decision-making process. Following surgery, long-term postoperative care is provided, including regularly scheduled office visits, monthly support group sessions and individual nutritional counseling.
“Current treatment for comorbid health conditions that does not involve bariatric surgery is successful in only 2% to 5% of morbidly obese patients,” says Dr. Wizman. “However, bariatric surgery can resolve comorbidities in 85% of morbidly obese patients.”
Helping Patients by Healing Chronic Wounds
The Center for Wound Care and Hyperbaric Medicine at Wellington Regional Medical Center specializes in problem wound management. Dedicated to providing exceptional outpatient clinical wound care and hyperbaric oxygen therapy, the center was recently given a Center of Distinction award for its exceptional healing rate of 92%. Many of its patients have been suffering from chronic, nonhealing wounds for years. When they are healed (in a median of 31 days), patients are extremely happy as measured by high satisfaction ratings. The center’s success has been enhanced through its relationship with Diversified Clinical Services (DCS), the world’s largest wound care management company.
Cutting-Edge Services Available
At the Center for Wound Care and Hyperbaric Medicine, each patient’s wound is evaluated thoroughly. Physicians and clinicians provide an integrated model of care, including involving the patients’ primary care physicians and specialists in their care. Case studies are provided to referring providers throughout treatment, including pictures that show the progression of healing.
At the Center for Wound Care and Hyperbaric Medicine, patients benefit from a multidisciplinary approach that involves a team of specialists: general surgeons, podiatrists, plastic surgeons, wound-certified nurses and certified hyperbaric technicians. Prior to treatment, the patient is evaluated thoroughly, and a treatment plan is written — keeping referring physicians informed throughout the process. Physicians specially trained in wound medicine focus on providing proven modalities, which are often too expensive and time consuming to be provided in a physician office. Diagnostic tests such as transcutaneous oximetry, vascular studies and procedures such as debridement can be provided in the center. Some patients require specialized treatment in a surgical suite or vascular lab.
The center’s care is guided by the latest clinical research and treatment experience for each wound type. The center uses evidence-based clinical pathways that have been based on DCS’s experience treating more than 2 million wounds. For patients with chronic wounds, hyperbaric oxygen therapy may present the best treatment option. Though not indicated for all patients, it can help patients achieve high-quality outcomes for wounds that have failed to heal through the use of conventional methods.
“Hyperbaric oxygen therapy is not for every patient,” says Steven Goff, M.D., Medical Director of the Center for Wound Care and Hyperbaric Medicine. “However, for certain patients — including patients who have radiation-induced injuries, complicated diabetic wounds and compromised skin grafts or flaps — it is medically approved by most payers. During treatment, high concentrations of oxygen are delivered to the blood stream, which is delivered directly to the wound, helping to accelerate healing from the inside out.”
The Center for Wound Care and Hyperbaric Medicine has four monoplace chambers, which provide patients with additional comfort.
“Having monoplace hyperbaric oxygen chambers really improves the patient experience,” says Susan Gauthier, Director of the Center for Wound Care and Hyperbaric Medicine. “In some centers, patients share a chamber with three or four other people; however, with monoplace chambers, patients are in the chamber alone and are able to rest comfortably, listen to music or watch television. Healing and preventing wounds is our sole mission. We educate patients about being diligent to prevent future wounds. Our goal is to help our medical community treat wounds successfully.”
To learn more about the bariatric surgical and wound care services available at Wellington Regional Medical Center, visit www.wellingtonregional.com.
MD News Vol. 9, No. 4, Palm Beaches