Wound Healing & Hyperbarics

The Wound Healing & Hyperbarics Program is committed to providing the highest quality wound care. Our full range of services includes wound and nutritional assessments, weekly physician visits, and patient/caregiver education. In addition, diagnostic evaluations, laboratory tests, vascular interventions, and pressure mapping are available.

PODCAST: Benefits of Wound Care & Hyperbarics

For patients who have a non-healing wound, or suffer from conditions that slow typical healing time, wound care is an effective method of treatment.

Click here to download the podcast or to read the transcript

A patient’s care is supported by an interdisciplinary wound healing team:

  • Vascular surgeons
  • Wound healing physicians (Hyperbaric medicine)
  • Foot & ankle specialists
  • Infectious disease specialists
  • Physical & occupational therapists
  • Plastic surgeons
  • Certified wound ostomy continence nurses

Sue's Story

One of Sue’s favorite things was to walk and play at the beach with her grandson. After a chronic wound on her foot that would not heal, she was not able to walk. With the help of the team at the Wound Healing & Hyperbaric practice, they got Sue back on her feet, literally! See Sue walk the beach again!

Our Specialty Programs

Nutrition Program

Nutrition Program

Food choices and nutritional status influence wound healing since serious wounds increase the energy, vitamin, mineral and protein requirements necessary to promote healing. Also, nutrients are lost in the fluid that weeps from wounds.

  1. The first priority is to eat sufficient calories from a balanced diet of nutritious foods. Plan healthy, balanced meals and snacks that include plenty of foods from all the food groups — protein, fruits, vegetables, dairy and grains.
  2. Include optimum amounts of protein. Aim for 20 to 30 grams of protein at each meal and 10 to 15 grams of protein with each snack. A piece of cooked chicken, lean meat or fish the size of a deck of cards (about 3 ounces) contains 20 to 25 grams of protein. One egg, 1 tablespoon of peanut butter and 1 ounce of cheese each contain 6 to 7 grams of protein. One cup of low-fat milk or yogurt contains 8 grams of protein.
  3. REMEMBER: Every ounce of meat or cheese contains 7-9 grams of protein.
  4. Stay well-hydrated with water and other unsweetened beverages such as tea, coffee, 100-percent fruit juice and milk, which also contain protein.
  5. Some wounds may require a higher intake of certain vitamins and minerals. Talk with a registered dietitian nutritionist for an individualized eating plan with optimum amounts of calories, protein, fluids, vitamins and minerals for your specific needs.
  6. For people with diabetes, controlling blood sugar levels is one of the best ways to prevent and treat a wound. Work with your physician and registered dietitian nutritionist to develop a personalized blood sugar management plan.
  7. Eat five or six meals a day
  8. Make each meal or snack count by having a protein in it.
  9. Take a multivitamin every day. (Vitamin C and zinc are especially important for wound healing)
  10. If you don’t have an appetite, add a protein powder to any food that you eat or try a liquid nutrition supplement, such as Ensure or Carnation Instant Breakfast.

Choose from these healthy beverages and protein-rich, vitamin packed foods to improve your healing process:

Water
Fruit Juices
Milk
Decaffeinated teas and coffee (not as main source of fluid intake)
Eggs
Dairy foods (cheese, yogurt)
Meats (beef, pork, chicken, fish)

Dried Beans, peas, nuts, seeds, peanut butter
Soy or Tofu products
Whole grains (cereal, breads, pasta, rice)
Leafy greens, yellow or orange vegetables
Citrus fruits and juices, strawberries and tomatoes

The Seating and Positioning Clinic

The Seating and Positioning Clinic

Patients who struggle to move may need more than just a wheelchair. Some have wounds associated with improper positioning and may need specialized mobility equipment or offloading. Our Seating and Positioning Clinic at helps people with special needs find seating systems that optimize their mobility while ensuring safe and effective positioning, so they can participate fully in activities of daily living.

Properly fitted mobility systems offer multiple benefits, including:

  • Increased access, comfort and ability to participate in activities of daily living.
  • Maximum independence within the home, school and community environment.
  • Increased participation in self-care, social, educational and vocational activities.
  • Improved symmetry, trunk control and alignment.
  • Reduced risk of secondary conditions caused by improper positioning, such as scoliosis, muscle contractures and pressure ulcers.
  • Positive impact on respiration, blood pressure, tone, skin integrity, bladder and bowel function, swallowing, eating and other oral-motor skills.

Our Team

The Seating Clinic includes skilled specialists with expertise in determining the solutions that best meet the needs of our patients and their families. Our team consists of:

  • Specialty Trained Physician (Physiatrist)
  • Occupational and physical therapists with special training in seating issues and technologies
  • On-site rehabilitation equipment specialists
  • Referring physicians
  • Wound Care experts and caregivers

What to Expect

Evaluation: During an initial evaluation, the physician will identify the primary reasons for the appointment and list all the factors affecting the patient's mobility and equipment needs, such as:

  • Musculoskeletal alignment and function
  • Functional ability, such as the ability to self-propel
  • Skin integrity
  • Transfer status
  • Pain levels
  • Status of current equipment
  • Home accessibility needs with recommendations for modifications, if needed
  • Nutritional status and risks

Program Features

We offer a number of specialized evaluations including:

  • Postural/balance evaluation – The Specialty Trained Physician and ATP (Assistive Technology Provider) team evaluate the patient's posture to identify postural supports and seating systems that the client requires for balance, improved posture, and ultimately, advanced function.
  • Pressure mapping evaluation – Maine Medical uses Tek Scan®, one of the newest pressure mapping technologies available, to determine areas of high risk for skin breakdown. This mapping system is an educational and assessment tool used to identify the areas of highest risk for skin breakdown and aids in the selection of a cushion and seating system to effectively redistribute pressures for each individual. The service can also be used to determine the effectiveness of existing equipment.
  • Mobility evaluation – A functional evaluation is initiated to determine the mobility device that might
    offer each person the greatest level of independence. Once the interdisciplinary team has determined that
    a mobility device is necessary, it is critical to identify the most appropriate piece of equipment.
  • Collaboration and assistive technology suppliers (ATS)
    Throughout the evaluation, prescription, education, ordering process and delivery, the physician and therapist work closely with the supplier from a company of the patient’s choice.

Skin Perfusion Clinic

Skin Perfusion Clinic

Evaluating wounds using the SensiLase System, which evaluates the circulatory conditions of the skin. These tests are conducted to assess blood flow of a patient’s legs, feet or toes. The SensiLase System conducts two tests, the Skin Perfusion Pressure (SPP) and the Pulse Volume Recording (PVR).

When treating patients with diabetes who have foot ulcers, the SensiLase System will tell us with approximately 90 percent accuracy which ulcers are likely to heal with good wound care and which are unlikely to heal despite an optimal wound care program. This level of accuracy greatly improves our ability to provide that individual with the most appropriate and effective wound care possible.

The SPP test is a useful tool for physicians as they determine the best course of therapy because the data provided enables the physician to:

  • Monitor disease progression in patients with conditions such as peripheral artery disease and other circulatory problems
  • Assess wound healing potential
  • Monitor pre- and post-therapy (e.g., surgery)
  • Plan arterial reconstruction and monitor post-procedure healing

The PVR test evaluates changes in arterial blood volume in the extremities with each pulse, and aids in determining the level and severity of arterial disease in the extremities. Performing a PVR with an SPP test provides correlation between the capillary disease process (micro) and the arterial component (macro) to offer further insight into a patient’s circulatory health.
PVR enables the clinician to assess lower extremity circulation, lower extremity arterial occlusive diseases and functional severity of the disease process. Pulse Volume Recording is of significance in that it:

  • Is indicative of vascular status
  • Provides qualitative patient information about arterial health
  • Immediately provides reliable, reproducible results

Noninvasive tests are much less stressful for our patients than some alternative choices. The SensiLase System gives us the value-added information we need to better diagnose disease and thus provide high quality care for our patients.

The SPP and PVR tests are especially valuable for treating wounds on persons with diabetes. According to the American Diabetes Association, between 60 and 70 percent of people with diabetes experience mild to severe loss of sensation in the feet, often causing foot ulcers to develop. The ADA further reports that amputation of limbs is 10 times more prevalent in these patients than in the general population. Appropriate monitoring and care is essential to minimize the necessity of amputation.

What to Expect

All of these tests use simple pressure cuffs and special sensors that send light or sound through the skin and into capillaries and arteries.

  1. The Skin Perfusion Pressure (SPP) Test: The SPP test measures blood flow to the tiny vessels in the feet. When P.A.D. is present, it can diminish blood flow to the feet. This test may also be called a “measurement of reactive hyperemia” by your physician since a pressure cuff is used to briefly stop blood flow in these small vessels. When the pressure is released, a small sensor under the cuff determines when the blood is flowing again in these tiny vessels. When a patient with diabetes has P.A.D., special care must be taken. Diabetes causes deterioration of tiny capillary vessels and arteries become hardened in a different way. This condition makes other tests that only assess larger vessels much less reliable in diagnosing P.A.D.
  2. The Pulse Volume Recording (PVR) Test: The PVR test uses the same pressure cuff as the SPP test. With the PVR test, the cuff is inflated to a lower pressure than with SPP. Each pulse produces small changes in the circumference of the leg under the cuff. These changes are measured and produce a printout tracing. A physician can view this tracing and determine if flow is normal or diminished. The PVR test can also be used to pinpoint where P.A.D. is located in your leg or foot.
  3. Ankle Brachial Index (ABI) Calculation: Using the same cuffs and a Doppler sensor, the ABI test measures and compares pressures in arteries in both feet and arms. The ratios of these pressure measurements provide valuable information about arterial health.

Compression Management & Lymphedema Program

Compression Management & Lymphedema Program

Our Compression Management Program will assist each patient on an individual basis. We realize that swelling is a diverse diagnosis and should be handled based on your needs and lifestyle. We are committed to create a personalized management program using our four-step approach for long-term home maintenance: Compression, Maintenance, Procurement, and Surveillance –CMPS.

Compression: The goal in our first step, Compress, is to stimulate fluid movement and begin to decrease the size of your extremities. The team can arrange for you to work with an MLD (Manual Lymphatic Drainage) Therapist to increase fluid movement and begin to help reduce your swelling. We can also provide the use of sequential compression device that can be used in the home, and at your convenience. Our team will work with you step-by-step so you are confident with the use and care of the equipment.

Maintenance: The second step in the CMPS Approach is to MAINTAIN what was achieved during step one, “Compress.” Low stretch bandages are wrapped around the arm/leg helping to decrease its size and continue to move the fluid out of the affected area. Our team will work with a friend or family member to instruct the proper techniques for applying the bandages. In addition, we can also provide a custom-fit, contour night-time appliance or other similar devices to help reduce swelling, even while at rest so that there is constant stimulation and fluid movement.
Procurement: Once our team establishes a solid routine of compression and maintenance, and maximum reduction is achieved, we prepare to procure it. Securing the extremity means that maximum reduction has been achieved and you are ready to be measured for a Custom Compression Garment. A custom-made garment is measured and properly fitted to the exact contour of your limb for comfort and compression. These custom garments, worn daily, along with continued use of the sequential compression device will help prevent further fluid accumulation and will help provide positive results.

Surveillance: To ensure that you remain ulcer free, we have a recall program that reappoints patients every six months for evaluation, this is final phase in the CMPS approach. Often times, there are changes in our body that occur and may necessitate a change in your compression garment prescription. We believe in having a proactive role in your management and therefore make every attempt to prevent problems before they occur.

With the right products, good timing, and helpful teaching, you can expect dramatic results improving your immediate condition, quality of life and ability for long-term independent care.

Pathomechanics & Gait Clinic

Pathomechanics & Gait Clinic

Gait issues can be indicative of underlying health problems and the cause for non-healing plantar foot wounds. Computerized gait analysis and identification of abnormal pathomechanics of the foot plays an important role in identifying abnormalities and asymmetries. Clinicians at Maine Medical’s Wound Healing and Hyperbaric Center can gather objective information on timing and plantar pressures for gait analysis with sophisticated computerized technology. This information helps diabetics and other “at risk” patients with prescription orthotics and shoe gear that will adequately offload any high pressure areas to heal their wounds while optimizing their mobility so they can participate fully in activities of daily living.

Properly prescribed orthotics, shoe gear and prosthetics offer multiple benefits, including:

  • Increased access, comfort and ability to participate in activities of daily living.
  • Healing a chronic wounds associated with abnormal gait and high pressure areas.

Our Team

Our Pathomechanics / Gait Analysis Program include skilled specialists with expertise in determining the solutions that best meet the needs of our patients.

Our team consists of:

  • Foot and Ankle Surgeon with specialty training in Abnormal and Normal Biomechanics of the foot & ankle.
  • Gait Analysis Technician with special training in gait issues and technologies
  • Referring physicians
  • Wound Care experts and caregivers

What to Expect

Evaluation: During an initial evaluation, the physician will identify the primary reasons for the appointment and list all the factors affecting the patient's gait and foot type:

  • Musculoskeletal alignment and function
  • Abnormal plantar foot pressures
  • Functional ability
  • Skin integrity
  • Orthotic and Prosthetic evaluation / prescription.
  • Pain levels
  • Effectiveness of current prescription
  • Nutritional status and risks
     
Photo Wound

Thin, sizeable sensors are inserted into the shoe allowing us to see exactly what’s happening to the foot during the stance phases of gait and activities. This allows us to capture plantar (bottom of the foot) pressures and force data. Patients move freely during testing in realistic environments. With this data we are able to educate our patients about their pathologies and treatments with comprehensive reports. In-shoe pressure analysis enables us to accurately determine the way your feet function within your shoes by using special insoles with force sensors.

This detailed analysis allows us to evaluate how the foot loads during walking and running and, where appropriate, we can compare different types of shoes or specific work related activities. This technology is the only way to analyze the interaction between the foot and the shoe.

For patients with orthotics (shoe inserts), we are able to compare the before and after effects to get a clearer picture of how the orthotics affect function.

Ostomy Clinic

Ostomy Clinic

Our Ostomy Clinic provides high quality preoperative and postoperative ostomy services to our patients and their families. Specially trained and certified wound, ostomy, and continence nurses provide education on temporary and permanent stomas, ensuring both patients and their families are comfortable and secure with every aspect of ostomy care. The goal so four ostomy services is for patients to return to normal daily activities as soon as possible so that they may enjoy the best quality of life. Our outpatient clinic partners with our patients and their physicians to ensure long-term care, support and resources as needed. Our services include:

  • Preoperative counseling teaching: help ally patients fears’ and anxieties and provides an opportunity to ask questions
  • Preoperative stoma marking: proper stoma placement helps patient’s avoid postoperative skin complications
  • Postoperative care: assessment for change in stoma size, contour, peristomal skin health and need for alteration in pouching system
  • Postoperative education: pouching system selection, self-care, and identifying and treating common stoma problems
  • Problem solving: assistance with pouching system failures (leaking), peristomal skin loss/rashes/wounds, and refitting of pouching system
  • Education and instruction in ostomy irrigation techniques
  • Information about lifestyle, intimacy, diet and clothing
  • Recommendations of complications such as peristomal hernias and stomal prolapses

Our Team

The nurses at our clinic are certified by the Wound, Ostomy, Continence Nursing Certification Board and have expertise in providing care and determining the solutions that best meet the needs of our patient’s and their families.

What to Expect

During the initial evaluation, the ostomy nurse will identify the primary reasons for the appointment and list all the factors affecting the patient’s physical and emotional needs regarding their ostomy.

Hyperbaric Program

Hyperbaric Program

Our world class Hyperbaric program is home to a team of highly-trained physicians, state-of-the-art hyperbaric chambers at their disposal.

Our Hyperbaric Chambers feature:

  • The ability to hear, see, talk to and monitor the patient during treatment
  • Superior electronic voice communications system to ensure safe, uninterrupted communication with patients
  • Extra-wide gurney that locks to chamber during patient transfer Patient Comfort
  • 33.5” internal diameter – the largest and longest acrylic tube in its class
  • Gurney is height adjustable for safe patient transfer and backrest adjustable from an angle of 0 to 57.5° for patient comfort
  • Accommodates a patient up to 400 pounds
  • Cool and quiet treatment Compartment

The benefits of hyperbaric therapy:

  • Stimulates new blood vessel growth and increases blood flow
  • Elevates the body’s natural immune defenses to fight infection and bacteria
  • Reduces swelling that may occur around damaged areas
  • Speeds up healing by increasing tissue oxygen levels to areas in the body where they are reduced due to injury or illness

Requesting an Appointment

To learn more about scheduling an appointment, please call our office at 207-662-HEAL (4325).

Please note: If you are experiencing a medical emergency, please call 9-1-1.

For Referring Physicians

To refer a patient, please fill out the referring physician form and fax back to Wound Healing & Hyperbarics. For questions, call 207-662-4325.