WHO NEEDS A WOUND CENTER?
-Chronic, poorly or nonhealing wounds that may require detailed evaluation and
special or prolonged care.
-Wounds or other problems that need hyperbaric oxygen therapy (HBOT).
-Treatment and follow-up of significant Brown Recluse Spider Bites (BRSB).
-Treatment and follow-up of MRSA infections(?).
-Patients with chronic lymph edema, usually secondary to chronic venous
stasis disease.
-Noninvasive testing for peripheral vascular disease (TCOM testing).

MEDICOLEGAL ISSUES
Early referral to wound care center for opinion of wound etiology, and advise on
care, may help avoid some family complaints and legal entanglements.

SPECIAL TRICKS
Bio-engineered skin substitutes ­ Apligraf and Dermagraft Advanced (and usually
expensive) dressings Advanced methods of controlling edema ­ new types of
compressive dressings, lymphedema pump, etc. Wound-VAC therapy Hyperbaric
oxygen therapy for selected cases.

TCOMs (TRANSCUTANEOUS OXIMETRY MEASUREMENT)
A non-invasive method of testing for arterial insufficiency by measuring the
cutaneous oxygen saturation low values may indicate the need for arteriography
and revascularization. Marginal values may indicate the use of hyperbaric oxygen
therapy. Surgeons commonly use this test to help determine levels of amputation
(i.e. at which level a patient is most likely to heal).