Via Christi 50+ presentation on vein treatments by Marilee McBoyle, medical director of Via Christi Wound Healing and Hyperbaric Therapy

1. Via Christi 50+ Lunch & LearnVia Christi 50+ Lunch & Learn
Veins, trains and automobilesVeins, trains and automobiles
Marilee McBoyle, MD, FACS
Medical Director
Via Christi Wound Healing and Hyperbaric Therapy1

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Today’s discussionToday’s discussion
 PART 1: Veins – legs and ankles
 PART 2: Diabetes – feet
 PART 3: Trauma – legs
 PART 4: Hyperbaric oxygen therapy

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But first…But first…
 A little bit about…
Via Christi
Wound Healing & Hyperbaric Therapy
 848 N. St. Francis, on the Via Christi Hospital St. Francis campus

4. Via ChristiVia Christi
Wound Healing & Hyperbaric TherapyWound Healing & Hyperbaric Therapy
 Our staff
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Via ChristiVia Christi
Wound Healing & Hyperbaric TherapyWound Healing & Hyperbaric Therapy
 Our facility

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PART 1: Venous (vein) ulcersPART 1: Venous (vein) ulcers
 Lower leg discomfort, swelling and ulcer
development
 Causes
 Prevention
 Treatment

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Interesting factsInteresting facts
 Venous (vein) ulcers are the most frequent
cause of leg ulcers
 Leg ulcers are slow to heal and fast to recur
 Chronic vein issues affect 1/3 of the adult
population

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PART 1: CausesPART 1: Causes
 Stasis (blood pooling)
 Insufficiency
 Varicose veins

9. Venous (vein) ulcersVenous (vein) ulcers
 Varicose veins
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10. CEAP scale for varicose veinsCEAP scale for varicose veins
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C2
C3
C4
C5-6
Swelling
V. veins
Skin
Changes
Ulcers
C1

11. Causes of venous (vein) ulcersCauses of venous (vein) ulcers
 Malfunctioning valves
 Blood pools
 Hemosiderin staining
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12. Causes of venous (vein) ulcersCauses of venous (vein) ulcers
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 Malfunctioning valves

13. Causes of venous (veins) ulcersCauses of venous (veins) ulcers
 Hemosiderin staining
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Lower leg

14. Prevention of venous (vein) ulcersPrevention of venous (vein) ulcers
 Muscle calf pump
 Compression hose
 Avoid long periods of standing
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15. Treatment of venous (vein) ulcersTreatment of venous (vein) ulcers
 Debridement
 Compression
 Skin substitutes
 Minimally invasive procedures
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16. Treatment of venous (vein) ulcersTreatment of venous (vein) ulcers
 Debridement
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17. Treatment of venous (vein) ulcersTreatment of venous (vein) ulcers
 Compression: 2-layer or 4-layer wraps
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18. Treatment of venous (vein) ulcersTreatment of venous (vein) ulcers
 Skin substitutes
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Ankle: Before
Ankle: After

19. We want to avoid this!We want to avoid this!
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Lower leg
Ankle

20. Part 2: Diabetic UlcersPart 2: Diabetic Ulcers
CAUTION:
 40-70% of all lower extremity amputations are
related to diabetes.
 85% of diabetic-related amputations are
preceded by a diabetic foot ulcer.
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21. PART 2: Diabetic ulcers, causesPART 2: Diabetic ulcers, causes
 Injury to blood vessels
 Neuropathic (can’t feel your feet)
 Charcot foot
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22. Causes of diabetic ulcerCauses of diabetic ulcer
 Neuropathic (can’t feel your feet)
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23. Causes of diabetic ulcersCauses of diabetic ulcers
 Charcot foot
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24. Prevention of diabetic ulcersPrevention of diabetic ulcers
 Blood sugar control / Hb A1C
 Correct shoes
 Checking feet every day (Including the sides
and bottom of feet, and in between the toes)
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25. Treatment of diabetic ulcersTreatment of diabetic ulcers
 Debridement
 Culture
 Blood sugar control
 Off-loading
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26. Treatment of diabetic ulcersTreatment of diabetic ulcers
 Debridement
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Bottom of foot: Before
Bottom of foot: After

27. Treatment of diabetic ulcersTreatment of diabetic ulcers
 Diabetic education – for blood sugar control
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28. Treatment of diabetic ulcersTreatment of diabetic ulcers
 Off-loading
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Bottom of foot
Lower leg cast

29. PART 3: Traumatic woundsPART 3: Traumatic wounds
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30. Traumatic woundsTraumatic wounds
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Ankle
Shin

31. PART 4:PART 4:
Hyperbaric Oxygen (HBO) therapyHyperbaric Oxygen (HBO) therapy
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32. What is Hyperbaric Oxygen therapy?What is Hyperbaric Oxygen therapy?
 100 percent oxygen given with increased
pressure
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33. Who is a candidate for HBO?Who is a candidate for HBO?
Most frequent indications
 Deep diabetic foot ulcers
 Radiation induced soft tissue injury
 Chronic refractory Osteomyelitis
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34. What to expect with HBOWhat to expect with HBO
 Hyperbaric oxygen therapy treatments take
about two hours
 You may feel pressure in your ears, similar to
traveling on a plane
 Glass windows are built into the hyperbaric
chamber, so you can watch TV or a movie
 In case of claustrophobia, medication can be
prescribed
 Treatment schedules vary, based on your
progress
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35. Celebrating wound healingCelebrating wound healing
“Let the rest of
your life be the
best of your life”
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36. Summary and questionsSummary and questions
Marilee McBoyle, MD, FACS
Medical Director
Via Christi Wound Healing and Hyperbaric Therapy
848 N. St. Francis, Suite 1900
Wichita, KS 67214
316.268.5881
viachristi.org/wound
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