Recently I had a wave of new patients with non- healing ulcers. So the best way to deal with it is to try to educate my patients to the best of my ability.
If someone has an opening in the skin- such as a new blister that opened up, or a small friction that seem to be getting worst, is important to seek medical advise. This is even more crucial if the patient happens to have diabetes or problems with circulations, or is on chemotherapy....
One of the major advantages we have now is the fact that we take cultures based on the DNA of bacteria or fungi that contaminate/infect an ulcer. The results are extremely accurate, fast and the test is covered by most insurances 100%.
Another major advantage is the fact that we are allowed to dispense to patients wound care supply and the tag is picked up by insurance so we do not need to send patient to a third party for supply.
Another advantage we have is that we can screen patients for blood flow in the extremities and detect arterial or venous disease before complications such as gangrene appear. If we detect an issue, we usually work with multiple vascular doctors and the flow in the extremity is restored, usually with stents, laser or medication. Once blood flow is restored to an ulcer, healing is within reach, and usually fast.
One other advantage we have is the fact that many times we are able to send a nurse to the patient's house, and ask to see patient once every week or two weeks here, while we have an " extension" of the doctor that treats the patient in the convenience of his/her house.
