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Thursday, April 5, 2012, 4:20 pm

Healdsburg hospital sees high demand for wound care

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    Hyperbaric chambers new for region; ‘real joy in seeing patients cured’

    Dr. Daniel Rose

    The chambers contain 100 percent oxygen, which helps white blood cells fend off infections while producing more collagen, according to Daniel Rose, medical director of the wound care program.

    HEALDSBURG – A new level of wound care is being provided by Healdsburg District Hospital, one that previously was unavailable anywhere in the North Bay and one that could help the hospital carve out a niche as it seeks to identify both health care needs and sustainable new business ventures.

    In July, the hospital announced the opening of its Northern California Wound Care facility on Healdsburg Avenue. The facility goes well beyond the traditional level of care, offering hyperbaric therapy for hard-to-heal wounds such as diabetic ulcers and radiation injury.

    The next closest hyperbaric care facilities are in San Francisco, and the hospital’s two chambers are already at full capacity, indicating a strong need, said Evan Rayner, chief executive officer of the North Sonoma County Healthcare District.

    “We know that there is a significant need for this type of comprehensive wound care,” Mr. Rayner said, adding that it’s augmented with traditional treatments. “We try to look at services that aren’t provided in the community, and we also want to have a good business program. This one has a business return on our investment that we like to have in some of our business models.”

    Patients utilizing the hyperbaric treatment are placed into a chamber that has an absolute atmospheric pressure of two or three. The pressure at absolute two is equal to the level of pressure at sea level; at absolute three, the pressure is equal to 3,000 feet above sea level. The chambers contain 100 percent oxygen, which helps white blood cells fend off infections while producing more collagen, according to Daniel Rose, medical director of the wound care program.

    There are two chambers in Healdsburg, each valued at approximately $250,000, Dr. Rose said.

    While the care is both unique and effective in staving off sores or even amputation, it is also covered by Medicare and most insurers, which provides for an economic benefit for the hospital, Mr. Rayner said.

    The Healdsburg wound center does not see patients for seven of 15 Medicare indications, due to the acuteness of some illnesses and because it is an outpatient center. Some illnesses not treated include acute carbon monoxide, gas embolism or gas gangrene, among others.

    The majority of the patients are diabetic, Dr. Rose said. In Sonoma County, 6 percent of the population is diabetic. Among people 65 years and older, 16.3 percent have diabetes, according to a California Health Interview study.

    Many of the wounds treated are diabetic ulcers and are Wagner grade III or higher, a classification used by Medicare. The wounds heal nicely, Dr. Rose added.

    “Most wounds will heal within the six-week time frame,” which is how long treatment typically lasts, Dr. Rose said. A typical session is 90 minutes, with 15 minutes of compression and decompression, five times a week. “It would heal just like normal skin with a scar,” he said. As it has been said, ”exceptional claims require exceptional proof,” Dr. Rose added. “There’s hard evidence that it works, so Medicare covers it.”

    Mr. Rayner said early returns on the care have proven promising, though it’s too early to determine a precise economic benefit. He said the wound care center is already receiving referrals from area hospitals, part of the strategy to eventually expand care.

    “We’re already at capacity, and we didn’t expect that for about a year. We’re much farther ahead than we thought,” Dr. Rose said. “People would otherwise have to drive to San Francisco five days a week.”

    Mr. Rayner said, “We’re accommodating patients all the way to Ukiah,” adding that the hospital has contracted with a transportation company for patients traveling long distances and who may not be in the best condition to transport themselves or have trouble finding a family member to provide transportation.

    For severe wounds, Dr. Rose said the amputation rate drops to 5 percent or 10 percent with hyperbaric care, compared with a 40 percent rate without it or with only traditional care.

    And with radiation injury – common among cancer patients – the cure rate can reach up to 95 percent if it’s treated soon enough.

    The hospital has partnered with Wound Care Advantage, a Southern California-based management firm that will assist in technical support, marketing and other best practices. It will assist in setting up electronic medical records at the Healdsburg wound center so that physicians who refer patients can have easy and accurate access to patient data, Mr. Rayner said.

    Dr. Rose, a family physician at the hospital for more than 30 years, said the hyperbaric wound care was exciting, even for a veteran who’s conducted thousands of surgeries.

    “That’s part of what brought me out of semi-retirement,” he said. “There is a real joy in seeing these patients get cured.”

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