Pressured to Heal

Time-tested therapy uses oxygen to heal chronic wounds.

Diving is Sue Leversee Grossman’s passion. She’s been a scuba diver for 51 years and a dive master for 30 years. To be in the ocean practically year-round was the main reason she and her husband moved to Florida from upstate New York in 1995. Sue was devastated last year when a health issue forced her out of the water completely.

Dr. John Yee of Lakewood Ranch Medical Center’s Center for Wound Healing & Hyperbaric Medicine in Bradenton treated Sue Leversee Grossman for a nonhealing foot wound.

Sue Leversee Grossman

“I’d been treating a diabetic ulcer on my foot for a long time when I developed osteomyelitis [inflammation of the bone] and ended up with an amputation in 2017,” shares the behavior health nurse. “I lost the little toe on my left foot.

“My orthopedic surgeon noticed I had minimal blood flow to my leg, so he sent me to Lakewood Ranch Medical Center for an angiogram and then an angioplasty, which helped. The wound from my amputation started healing.”

At the same time, however, Sue was also treating a second wound that was not healing.

“I was moving into a new place in February a year ago,” she recalls. “I was barefoot and carrying boxes. I ripped my foot open on a door jamb. This sore was under the big toe, also on my left foot.

“During the time we were treating my wounds, I still went in the water all the time. I eventually developed an infection in the wound on my big toe, and the wound just wouldn’t go away.”

Sue says it was a struggle for her after the open sore got infected. It caused her intense pain and prevented her from doing many of her activities as usual.

“It kept me from swimming, and that’s why we moved into that complex in the first place, because it had a heated pool,” she states. “It was very painful to walk on my left foot because of that big toe wound. I worked in a wheelchair for five months. It was at that point when I went to see Dr. Yee.”

Dr. Yee is John Yee, MD, medical director of the Center for Wound Healing & Hyperbaric Medicine at Lakewood Ranch Medical Center. He is certified in wound care, a branch of medicine that specializes in treating chronic wounds that are very difficult to heal. These include wounds associated with diabetes and venous disease, as well as pressure ulcers.

Sue gained confidence in Dr. Yee’s ability to help her during her very first visit.

“Dr. Yee did the most thorough new patient exam that I’ve ever had, and this was for an ulcer on my foot,” she describes. “I was really impressed, and I’m a nurse. In the beginning,
Dr. Yee debrided the wound and used special dressings on it, then he recommended a series of hyperbaric sessions.”

As a scuba diver, Sue is familiar with hyperbaric medicine. It’s been used for years to treat divers who get compression sickness, or the bends, from surfacing too quickly. Today, its role in medicine has expanded to include the treatment of chronic wounds. Typically, people are treated in pressurized rooms or tubes called hyperbaric chambers.

“Patients generally spend ninety minutes per session in the hyperbaric chamber,” explains Dr. Yee. “We bring the pressure to one atmosphere below sea level, which is equal to about thirty-three feet underwater. In the chamber, they breathe pure oxygen, which saturates the bloodstream.

“When blood is saturated with oxygen, it stimulates new blood vessel growth and opens up existing arteries. This provides more blood flow to the compromised area, so we can deliver antibiotics directly to the wound, which promotes healing.”

Combination for Closure

Sue arrived at the Center for Wound Healing & Hyperbaric Medicine at Lakewood Ranch Medical Center in mid September 2017. After Dr. Yee performed his evaluation, he and his team developed a treatment plan for Sue using various wound care measures.

“Sue was referred to us by her podiatrist, who asked if we could do something conservatively to close the wound on her foot without resorting to reconstructive surgery,” notes Dr. Yee. “We had the obstacles of infection and offloading her foot throughout the process, so we had to keep her off of her feet and out of the water.”

The Center for Wound Healing & Hyperbaric Medicine uses advanced methods to treat nonhealing wounds, and they used several of these methods with Sue. One method was a special collagen dressing that promotes tissue growth, granulation and wound closure.

“When we weren’t seeing enough growth from that, we took the next step and applied an allograft,” reports Dr. Yee. “An allograft is a skin graft using tissue from an animal or human. We most commonly use tissue from a human placenta.

“That allograft tissue is full of growth factors and healing molecules. First, we clean the wound, then apply the allograft. This starts a cascade of events when one growth factor stimulates another, and they eventually prompt granulation and healing.”

After those measures failed to fully provide the desired results, Dr. Yee recommended the hyperbaric chamber. The combination of treatments used by Dr. Yee and his team finally proved successful in closing the wound on Sue’s big toe.

“It would have happened sooner,” stresses Dr. Yee, “but during the first thirty days of wound closure, the closure is very fragile, and the wound can easily reopen. This happened to Sue. To protect her fragile closure, we put her in a total contact cast to offload the pressure on her foot.

“Pressure from everyday activities such as going to the restroom or getting food to eat might not seem like much, but it is enough to keep a wound alive and open. The contact cast helped Sue reduce the pressure from even these minor events.”

Phenomenal Experience

Sue’s wound treatment plan at the Center for Wound Healing & Hyperbaric Medicine included five sessions a week for eight weeks in the center’s hyperbaric chamber. She shares that it didn’t take long after beginning the sessions to notice changes in her body.Dr. John Yee of Lakewood Ranch Medical Center’s Center for Wound Healing & Hyperbaric Medicine in Bradenton treated Sue Leversee Grossman for a nonhealing foot wound.

“The treatment was fabulous,” she marvels. “I started feeling different immediately. When I got out of the chamber, I had more strength and energy. My nails and skin improved, everything improved.

“The improvement in my wound started right away and got progressively better. It healed pretty well once I started spending time in the hyperbaric chamber.”

She’s grateful to Dr. Yee and the team at the Center for Wound Healing & Hyperbaric Medicine for all they did for her.

“My experience at the wound center was fantastic,” she says. “Their care was phenomenal. I’ve never had a group of people take better care of me than they did. Every single one of them was professional, compassionate and totally there for me. Now that I’m discharged, I miss them. It was like being with family.

“On a scale of one to ten, Dr. Yee and his team at the Center for Wound Healing and Hyperbaric Medicine at Lakewood Ranch Medical Center are a fifteen. They’re awesome!”

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