Three centers devoted to wound care will open at hospitals in the Buffalo area over the

next few months, including one today at St. Joseph Hospital, a reflection of the growing

sophistication of treating difficult wounds.

The units, managed in partnership with companies that specialize in chronic, nonhealing

wounds, focus on such problems as foot ulcers in diabetics, pressure ulcers in the elderly and

challenging wounds in trauma patients.

They come outfitted with modern hyperbaric oxygen chambers, a therapy that aids healing in

certain patients and reduces such complications as amputations.

"There is pretty good evidence that wounds heal better and faster when cared for in a

center that specializes in wounds," said Dr. Lee C. Ruotsi, a certified wound specialist.

Ruotsi serves as medical director of the Catholic Health wound care program.

The hospital system is opening a wound healing center with two hyperbaric chambers at Sisters Hospital, St.

Joseph Campus, in Cheektowaga. Another center is scheduled to open in the fall at the hospital

network's Mercy Ambulatory Care Center in Orchard Park.

Meanwhile, Erie County Medical Center plans to open a wound care center at its Grider

Street campus in late summer.

The new centers join similar hospital-operated units in the region at Olean General,

Millard Fillmore at Gates Circle, Mount St. Mary in Lewiston and Kenmore Mercy's Sheridan

Healthcare Center in the Town of Tonawanda.

"For us, the driving force was our trauma and burn units, and wanting to take the care of

wounds to the next level. It's a quality issue," said Mark Barabas, president and chief

operating officer of ECMC.

Officials at ECMC, which cares for about 250 trauma cases a month, estimate the wound care

center will experience about 6,000 patient visits a year initially and, perhaps, 7,000 visits

within three years.

First-year expenses to operate the ECMC center, a project that still requires state Health

Department approval, are estimated at $850,000. The hospital has a five-year contract with

Diversified Clinical Services, a Jacksonville, Fla., company that manages wound care centers

at about 300 hospitals nationwide. Catholic Health is using a competing Boca Raton, Fla.,

company that specializes in wound care, Precision Health Care.

Such companies provide the equipment, data tracking, personnel training and management

expertise needed to operate a program.

Wound care generally involves such treatment as removal of dead tissue, infection control

and effective use of dressings. The field also has seen advances in the last decade or so,

including skin substitutes and the development of single-patient acrylic hyperbaric chambers

that resemble cylindrical fish tanks.

Hyperbaric chambers deliver 100 percent oxygen under pressure and are currently approved

for 13 medical conditions, including diabetic foot and lower leg wounds, arterial

insufficiency ulcers and traumatic crash injuries.

Research has found that hyperbaric therapy seems to reduce the number of major amputations

in people with diabetes who have chronic foot ulcers and may reduce the size of wounds caused

by disease to the veins of the leg, according to the Cochrane Collaboration, an independent

organization that reviews medical studies.

An estimated 10 percent to 15 percent of wound care patients are candidates for hyperbaric

treatment, Ruotsi said.

Experts say the demand for wound care is on the rise as the proportion of elderly in the

population grows, and the prevalence of diabetes, heart disease and obesity increases, all of

which result in circulation problems that lead to chronic wounds. Often, a minor cut or skin

crack can worsen quickly into a large wound that fails initial treatment.

For hospitals, the management of wounds in patients crosses multiple disciplines, from

surgery and emergency care to podiatry and geriatrics. The movement is toward carving out

wound care at a hospital as a specialized center to standardize therapy and to avoid the long

hospital stays and serious complications that can arise from a nonhealing wound, especially in

older and chronically ill patients.

"The concept of specializing in wound care is becoming more popular and important," Ruotsi

said.