vein & wound services
vein & wound services
Wound Debridment In Los Angles & Ventura County
Debridement is a well-established concept in problem wound bed preparation. It involves the removal of all necrotic tissue (skin, tendon, bone, muscle), biofilm, slough, fibrinous exudates, and hypovascular fibrous tissue from the wound site (burns, ulcers, etc) to reduce the risk of infection, facilitate healing, or permit the effective application of advanced wound products. Ultimately, debridement is aimed at improving wound healing outcomes. Wound debridement is performed by our wound care specialist in Los Angeles, Dr. Haimesh Shah.
Types Of Debridement
When a wound is exposed to the air, the dead tissue forms a hard crust known as an eschar that can hamper the healing process and lead to abscesses, bacteria, and infection.
Wound debridement is usually done in 4 different ways, and the physician chooses the most appropriate one depending on the amount of tissue to be removed. These include:
Wound debridement is usually done in 4 different ways, and the physician chooses the most appropriate one depending on the amount of tissue to be removed. These include:
Mechanical Debridement
Mechanical debridement is one of the oldest forms of wound debridement. This method uses a procession of moist to wet dressings, which are then manually removed. This causes non-selective debridement of necrotic tissue and slough (and sometimes healthy tissue as well).
Autolytic Debridement
Autolytic debridement uses the body’s own enzymes to break down tough eschar and slough. It does not damage healthy skin, but breaks down dead and devitalized tissue over time quite effectively. The idea behind autolytic debridement is to keep wound fluids in constant contact with the wound. This is achieved with the use of semi-occlusive or occlusive dressings..
Enzymatic Debridement
Enzymatic debridement utilizes chemical agents to break down necrotic tissue. They are most useful for debriding wounds with a large amount of necrotic tissue or slough formation.
Excisional Debridment
Also referred to as sharp debridement, excisional debridement involves the use of a scalpel, scissors, or ultrasonic device to remove all unhealthy tissue that is dead or severely infected at the wound base or margin to provide a healthy, active wound that supports healing. It is done in the office, under local anesthesia.
Wound Biopsy In Los Angles & Ventura County
If you have a chronic non-healing wound or atypical wound, your wound care specialist will recommend to have a wound biopsy. A wound biopsy is the most definitive diagnostic test to evaluate the cause of the non-healing wound and can be performed in the office.
There are different types of wound biopsies however wound biopsies are performed using one of the following methods:
Incisional biopsy – With this procedure, only a small piece of the wound tissue is removed in order to identify the composition of the lesion.
Punch biopsy – This procedure is done with a 4 mm circular blade attached to a pencil-like handle, which is rotated down through the epidermis and dermis, and into the subcutaneous tissue of the wound margins, producing a cylindrical core of tissue.
There are different types of wound biopsies however wound biopsies are performed using one of the following methods:
Incisional biopsy – With this procedure, only a small piece of the wound tissue is removed in order to identify the composition of the lesion.
Punch biopsy – This procedure is done with a 4 mm circular blade attached to a pencil-like handle, which is rotated down through the epidermis and dermis, and into the subcutaneous tissue of the wound margins, producing a cylindrical core of tissue.
How Wound Biopsy in Los Angeles & Ventura is Performed
Wound biopsy is done in the office under local anesthesia. The sample is sent to the pathologist for review and diagnosis.
Is Biopsy right for your non-healing wound?
For more information or to discuss whether wound biopsy is recommended for your non-healing ulcer, please contact us @ 310 402 2849 or contact us online here.
Dr. Haimesh Shah of Vein and Wound Institute offers wound biopsy as part of our wound care & management services to patients in Los Angeles & Ventura County including Oxnard, Simi Valley, Thousand Oaks, & more.
Dr. Haimesh Shah of Vein and Wound Institute offers wound biopsy as part of our wound care & management services to patients in Los Angeles & Ventura County including Oxnard, Simi Valley, Thousand Oaks, & more.
Skin Graft Surgery In Los Angeles & Ventura County
What is Bio-engineered Skin Graft?
With increasing traffic density, unpredictable road conditions, and
Your doctor may recommend bio-engineered skin graft or substitutes to help cover a chronic wound a wound that fails to heal itself within a specific time period. There are different ways to manage chronic wounds, including the use of specialized dressings, surgery like skin flaps and grafts from the patient’s own body, or bio-engineered skin grafts.
Bioengineered skin grafts comprise an outer epidermal layer and a dermal layer embedded into a support structure (acellular matrix) to create a biological skin substitute.
Your doctor may recommend bio-engineered skin graft or substitutes to help cover a chronic wound a wound that fails to heal itself within a specific time period. There are different ways to manage chronic wounds, including the use of specialized dressings, surgery like skin flaps and grafts from the patient’s own body, or bio-engineered skin grafts.
Bioengineered skin grafts comprise an outer epidermal layer and a dermal layer embedded into a support structure (acellular matrix) to create a biological skin substitute.
Skin grafts can be derived from human or non-human tissue. Bio-engineered skin grafts are derived either from human placenta (EpiFix® or Grafix®), neonatal foreskin (Dermagraft® or Apligraf®) or porcine stomach lining (Oasis®).
Most of the bio-engineered skin grafts are produced commercially and grown from neonatal (allogeneic) foreskin. This skin graft is preferred because:
Most of the bio-engineered skin grafts are produced commercially and grown from neonatal (allogeneic) foreskin. This skin graft is preferred because:
- It is characterized by vigorous cell growth with high metabolic activity
- It is obtained conveniently from healthy babies during circumcision
- It is rich in epidermal keratinocyte stem cells
- There are hardly any allergic reactions against these cells
Properties of Bio-engineered Skin Grafts in Los Angeles
Bioengineered skin graft is intended to temporarily assume the role of the epidermis/dermis until the patient’s skin self-repairs or until a definite skin replacement is obtained with a skin graft or some other cultured equivalent.
Research suggests that bioengineered skin grafts hastens the wound healing process by introducing living cells to restore the necessary conditions for repair, including structural support, a moist wound environment, and growth factors (including cytokines) that stimulate natural immune response and foster tissue regeneration.
Research suggests that bioengineered skin grafts hastens the wound healing process by introducing living cells to restore the necessary conditions for repair, including structural support, a moist wound environment, and growth factors (including cytokines) that stimulate natural immune response and foster tissue regeneration.
Here are some of the advantages of using bioengineered skin grafts:
- Overall cost to heal wound is reduced
- Biodegradable
- Indefinite shelf life under minimal storage requirements for selected grafts
- Fast and unremitting adherence to the wound surface
- Permits transmission of water vapor – similar to normal skin
- Flexible and pliable so it can easily conform to any wound surface
- Inner surface structure promotes cell proliferation/migration of new tissue
- No systemic toxicity
- Non-antigenic – meaning it won’t be rejected by the host’s immune system
Who can benefit from Bioengineered skin grafts?
- Severe burn wounds
- Leg ulcers caused by venous insufficiency, diabetic foot ulcers, pressure ulcers (bedsores), and ulcers caused by peripheral arterial disease
- Breast reconstruction surgery
- Ulcers related to systemic sclerosis
- Acute surgical wounds
- Pyoderma gangrenosum
- Epidermolysis bullosa (EB)
Our physician-based program will work within the skilled nursing facilities existing formulary and protocols to help keep dressing costs down.
We will work as part of a wound care team with your Nurses, Dieticians and Physical Therapists to improve healing and reduce costs.
Let Vein and Wound Institute be your wound care experts supporting your patients or facility and quality assurance!
We will work as part of a wound care team with your Nurses, Dieticians and Physical Therapists to improve healing and reduce costs.
Let Vein and Wound Institute be your wound care experts supporting your patients or facility and quality assurance!
What are the advantages over skin grafts (derived from patient’s own body)
- Less pain than skin grafting
- Fewer complications than skin grafting
- Done in the office setting
- No anesthesia needed
- No need for graft harvesting and wound healing at the harvest site
Negative Pressure Wound Therapy Los Angeles & Ventura County
Also known as vacuum assisted wound closure (VAC) therapy, Negative Pressure Wound Therapy (NPWT) refers to a wound management system that applies gentle but continuous or intermittent suction through a wound dressing and a small electrical pump to facilitate faster wound healing by:
- Eliminating excess fluid
- Protecting the wound from germs
- Fostering the growth of healthy tissue
- Increasing blood supply to the wound site
The treatment has become very popular for the management of acute and chronic wounds.
Who Is A Good Candidate For Vacuum Assisted Closure In Los Angeles?
Vacuum assisted closure, or negative pressure wound therapy, may be used to aid in the healing of different types of wounds, including:
- Venous ulcers
- Pressure ulcers
- Diabetic ulcers
- Surgical and acute wounds prone to infection
- Chronic wounds
- First and second degree burns
- Arterial ulcers
- Wounds with a lot of drainage
Negative pressure wound therapy may be performed in conjunction with other treatments, such as antibiotic therapy, wound debridement and irrigation, pain management, and nutritional management.
The procedure is usually done in a hospital setting where a health care professional can evaluate your overall health and monitor for worsening condition or infection. But if you are medically fit for discharge and still need NPWT, arrangements can be made to continue the therapy at home.
The procedure is usually done in a hospital setting where a health care professional can evaluate your overall health and monitor for worsening condition or infection. But if you are medically fit for discharge and still need NPWT, arrangements can be made to continue the therapy at home.
How Is Negative Pressure Wound Therapy Performed
- First, sterile open-cell foam is cut to the required size and packed into the wound to act as a filter to prevent large particles (dead tissue, slough, blood clots) from clogging the suction system. If the wound is not sufficiently deep, open weave gauze (or any other honeycomb dressing textiles) can be substituted for the open-cell foam.
- After applying the foam, the wound is covered with a polyurethane occlusive dressing to create an airtight seal around the wound. A pump is then connected to the dressing. Negative pressure is applied to create a vacuum environment around the wound. The pump contains a ‘collection chamber’ canister for moisture and drainage from the wound to collect.
- The pump is programmed for suction strength, duration of time it will run, and whether the pressure should be continuous or intermittent. The standard pressure range is -125 to -75 mmHg depending on the type of wound and patient’s tolerance level.
Patients claim to feel a slight pulling sensation for a few seconds when the suction starts, which then disappears. The dressing is changed usually 2-3 times a week. To manage any pain and discomfort, you may be given some pain medication before changing the dressing and for the entire duration of the treatment.
The treatment involves the application of a sealed wound dressing that is connected to a pump to create a vacuum or negative pressure environment in the wound. Depending on the type of wound and its location, the vacuum can be applied continuously or intermittently.
The treatment involves the application of a sealed wound dressing that is connected to a pump to create a vacuum or negative pressure environment in the wound. Depending on the type of wound and its location, the vacuum can be applied continuously or intermittently.
Excisional Debridement
Wound Debridment In Los Angles & Ventura County
Debridement is a well-established concept in problem wound bed preparation. It involves the removal of all necrotic tissue (skin, tendon, bone, muscle), biofilm, slough, fibrinous exudates, and hypovascular fibrous tissue from the wound site (burns, ulcers, etc) to reduce the risk of infection, facilitate healing, or permit the effective application of advanced wound products. Ultimately, debridement is aimed at improving wound healing outcomes. Wound debridement is performed by our wound care specialist in Los Angeles, Dr. Haimesh Shah.
Types Of Debridement
When a wound is exposed to the air, the dead tissue forms a hard crust known as an eschar that can hamper the healing process and lead to abscesses, bacteria, and infection.
Wound debridement is usually done in 4 different ways, and the physician chooses the most appropriate one depending on the amount of tissue to be removed. These include:
Wound debridement is usually done in 4 different ways, and the physician chooses the most appropriate one depending on the amount of tissue to be removed. These include:
Mechanical Debridement
Mechanical debridement is one of the oldest forms of wound debridement. This method uses a procession of moist to wet dressings, which are then manually removed. This causes non-selective debridement of necrotic tissue and slough (and sometimes healthy tissue as well).
Autolytic Debridement
Autolytic debridement uses the body’s own enzymes to break down tough eschar and slough. It does not damage healthy skin, but breaks down dead and devitalized tissue over time quite effectively. The idea behind autolytic debridement is to keep wound fluids in constant contact with the wound. This is achieved with the use of semi-occlusive or occlusive dressings..
Enzymatic Debridement
Enzymatic debridement utilizes chemical agents to break down necrotic tissue. They are most useful for debriding wounds with a large amount of necrotic tissue or slough formation.
Excisional Debridment
Also referred to as sharp debridement, excisional debridement involves the use of a scalpel, scissors, or ultrasonic device to remove all unhealthy tissue that is dead or severely infected at the wound base or margin to provide a healthy, active wound that supports healing. It is done in the office, under local anesthesia.
Wound Biospy
Wound Biopsy In Los Angles & Ventura County
If you have a chronic non-healing wound or atypical wound, your wound care specialist will recommend to have a wound biopsy. A wound biopsy is the most definitive diagnostic test to evaluate the cause of the non-healing wound and can be performed in the office.
There are different types of wound biopsies however wound biopsies are performed using one of the following methods:
Incisional biopsy – With this procedure, only a small piece of the wound tissue is removed in order to identify the composition of the lesion.
Punch biopsy – This procedure is done with a 4 mm circular blade attached to a pencil-like handle, which is rotated down through the epidermis and dermis, and into the subcutaneous tissue of the wound margins, producing a cylindrical core of tissue.
There are different types of wound biopsies however wound biopsies are performed using one of the following methods:
Incisional biopsy – With this procedure, only a small piece of the wound tissue is removed in order to identify the composition of the lesion.
Punch biopsy – This procedure is done with a 4 mm circular blade attached to a pencil-like handle, which is rotated down through the epidermis and dermis, and into the subcutaneous tissue of the wound margins, producing a cylindrical core of tissue.
How Wound Biopsy in Los Angeles & Ventura is Performed
Wound biopsy is done in the office under local anesthesia. The sample is sent to the pathologist for review and diagnosis.
Is Biopsy right for your non-healing wound?
For more information or to discuss whether wound biopsy is recommended for your non-healing ulcer, please contact us @ 310 402 2849 or contact us online here.
Dr. Haimesh Shah of Vein and Wound Institute offers wound biopsy as part of our wound care & management services to patients in Los Angeles & Ventura County including Oxnard, Simi Valley, Thousand Oaks, & more.
Dr. Haimesh Shah of Vein and Wound Institute offers wound biopsy as part of our wound care & management services to patients in Los Angeles & Ventura County including Oxnard, Simi Valley, Thousand Oaks, & more.
Bioengineered Skin Grafts
Skin Graft Surgery In Los Angeles & Ventura County
What is Bio-engineered Skin Graft?
With increasing traffic density, unpredictable road conditions, and
Your doctor may recommend bio-engineered skin graft or substitutes to help cover a chronic wound a wound that fails to heal itself within a specific time period. There are different ways to manage chronic wounds, including the use of specialized dressings, surgery like skin flaps and grafts from the patient’s own body, or bio-engineered skin grafts.
Bioengineered skin grafts comprise an outer epidermal layer and a dermal layer embedded into a support structure (acellular matrix) to create a biological skin substitute.
Your doctor may recommend bio-engineered skin graft or substitutes to help cover a chronic wound a wound that fails to heal itself within a specific time period. There are different ways to manage chronic wounds, including the use of specialized dressings, surgery like skin flaps and grafts from the patient’s own body, or bio-engineered skin grafts.
Bioengineered skin grafts comprise an outer epidermal layer and a dermal layer embedded into a support structure (acellular matrix) to create a biological skin substitute.
Skin grafts can be derived from human or non-human tissue. Bio-engineered skin grafts are derived either from human placenta (EpiFix® or Grafix®), neonatal foreskin (Dermagraft® or Apligraf®) or porcine stomach lining (Oasis®).
Most of the bio-engineered skin grafts are produced commercially and grown from neonatal (allogeneic) foreskin. This skin graft is preferred because:
Most of the bio-engineered skin grafts are produced commercially and grown from neonatal (allogeneic) foreskin. This skin graft is preferred because:
- It is characterized by vigorous cell growth with high metabolic activity
- It is obtained conveniently from healthy babies during circumcision
- It is rich in epidermal keratinocyte stem cells
- There are hardly any allergic reactions against these cells
Properties of Bio-engineered Skin Grafts in Los Angeles
Bioengineered skin graft is intended to temporarily assume the role of the epidermis/dermis until the patient’s skin self-repairs or until a definite skin replacement is obtained with a skin graft or some other cultured equivalent.
Research suggests that bioengineered skin grafts hastens the wound healing process by introducing living cells to restore the necessary conditions for repair, including structural support, a moist wound environment, and growth factors (including cytokines) that stimulate natural immune response and foster tissue regeneration.
Research suggests that bioengineered skin grafts hastens the wound healing process by introducing living cells to restore the necessary conditions for repair, including structural support, a moist wound environment, and growth factors (including cytokines) that stimulate natural immune response and foster tissue regeneration.
Here are some of the advantages of using bioengineered skin grafts:
- Overall cost to heal wound is reduced
- Biodegradable
- Indefinite shelf life under minimal storage requirements for selected grafts
- Fast and unremitting adherence to the wound surface
- Permits transmission of water vapor – similar to normal skin
- Flexible and pliable so it can easily conform to any wound surface
- Inner surface structure promotes cell proliferation/migration of new tissue
- No systemic toxicity
- Non-antigenic – meaning it won’t be rejected by the host’s immune system
Who can benefit from Bioengineered skin grafts?
- Severe burn wounds
- Leg ulcers caused by venous insufficiency, diabetic foot ulcers, pressure ulcers (bedsores), and ulcers caused by peripheral arterial disease
- Breast reconstruction surgery
- Ulcers related to systemic sclerosis
- Acute surgical wounds
- Pyoderma gangrenosum
- Epidermolysis bullosa (EB)
Our physician-based program will work within the skilled nursing facilities existing formulary and protocols to help keep dressing costs down.
We will work as part of a wound care team with your Nurses, Dieticians and Physical Therapists to improve healing and reduce costs.
Let Vein and Wound Institute be your wound care experts supporting your patients or facility and quality assurance!
We will work as part of a wound care team with your Nurses, Dieticians and Physical Therapists to improve healing and reduce costs.
Let Vein and Wound Institute be your wound care experts supporting your patients or facility and quality assurance!
What are the advantages over skin grafts (derived from patient’s own body)
- Less pain than skin grafting
- Fewer complications than skin grafting
- Done in the office setting
- No anesthesia needed
- No need for graft harvesting and wound healing at the harvest site
pressure-wound-therapy
Negative Pressure Wound Therapy Los Angeles & Ventura County
Also known as vacuum assisted wound closure (VAC) therapy, Negative Pressure Wound Therapy (NPWT) refers to a wound management system that applies gentle but continuous or intermittent suction through a wound dressing and a small electrical pump to facilitate faster wound healing by:
- Eliminating excess fluid
- Protecting the wound from germs
- Fostering the growth of healthy tissue
- Increasing blood supply to the wound site
The treatment has become very popular for the management of acute and chronic wounds.
Who Is A Good Candidate For Vacuum Assisted Closure In Los Angeles?
Vacuum assisted closure, or negative pressure wound therapy, may be used to aid in the healing of different types of wounds, including:
- Venous ulcers
- Pressure ulcers
- Diabetic ulcers
- Surgical and acute wounds prone to infection
- Chronic wounds
- First and second degree burns
- Arterial ulcers
- Wounds with a lot of drainage
Negative pressure wound therapy may be performed in conjunction with other treatments, such as antibiotic therapy, wound debridement and irrigation, pain management, and nutritional management.
The procedure is usually done in a hospital setting where a health care professional can evaluate your overall health and monitor for worsening condition or infection. But if you are medically fit for discharge and still need NPWT, arrangements can be made to continue the therapy at home.
The procedure is usually done in a hospital setting where a health care professional can evaluate your overall health and monitor for worsening condition or infection. But if you are medically fit for discharge and still need NPWT, arrangements can be made to continue the therapy at home.
How Is Negative Pressure Wound Therapy Performed
- First, sterile open-cell foam is cut to the required size and packed into the wound to act as a filter to prevent large particles (dead tissue, slough, blood clots) from clogging the suction system. If the wound is not sufficiently deep, open weave gauze (or any other honeycomb dressing textiles) can be substituted for the open-cell foam.
- After applying the foam, the wound is covered with a polyurethane occlusive dressing to create an airtight seal around the wound. A pump is then connected to the dressing. Negative pressure is applied to create a vacuum environment around the wound. The pump contains a ‘collection chamber’ canister for moisture and drainage from the wound to collect.
- The pump is programmed for suction strength, duration of time it will run, and whether the pressure should be continuous or intermittent. The standard pressure range is -125 to -75 mmHg depending on the type of wound and patient’s tolerance level.
Patients claim to feel a slight pulling sensation for a few seconds when the suction starts, which then disappears. The dressing is changed usually 2-3 times a week. To manage any pain and discomfort, you may be given some pain medication before changing the dressing and for the entire duration of the treatment.
The treatment involves the application of a sealed wound dressing that is connected to a pump to create a vacuum or negative pressure environment in the wound. Depending on the type of wound and its location, the vacuum can be applied continuously or intermittently.
The treatment involves the application of a sealed wound dressing that is connected to a pump to create a vacuum or negative pressure environment in the wound. Depending on the type of wound and its location, the vacuum can be applied continuously or intermittently.
Click here to view more reviews
Our Patient Testimonials
Loading reviews…