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Every wound has its unique set of circumstances. Some heal quickly, others do not.

The Wound Healing Center at Health Central is equipped and staffed to address chronic wounds. Tucked inside high-tech facilities off Old Winter Garden Road in Ocoee, a team of nurses, therapists and a physician cares for people whose open sores have resisted traditional treatment. The success rate: 80 percent heal in 12 to 16 weeks.

The causes of open sores are complex, and the Wound Healing Center at Health Central has the expertise in all of the major areas necessary to handle their varied circumstances and challenges. In some cases, simply changing medication is all that is needed, while in other cases, a much more complex treatment plan is required.

Dr. Nicholas Bagnoli is the latest to join the center, as the new medical director. Bagnoli will be working with area physicians to provide specialized wound care for patients with non-healing wounds, as well as overseeing the clinical operations of the Wound Healing Center.

Bagnoli completed his physical medicine and rehabilitation training at Sinai-Johns Hopkins Hospital in Baltimore, Md., in 1997, and is board-certified in physical medicine and rehabilitation. He has been providing wound care services to Central Florida for the past 10 years. Bagnoli’s special interests include treating patients with lymphedema, decubitus wounds, and diabetic foot wounds. He also has expertise in the treatment of hyperbaric medicine.

Physicians can refer their most chronic wound patients for treatment at the center on an outpatient basis and follow up with them after treatments have been completed. Physicians can remain involved throughout the patient’s process, reviewing detailed reports that document the patient’s progress and meeting with the center’s physicians for consultations.

Treatment options include bio-engineered skin substitutes, debridement, growth factor therapy, hyperbaric oxygen therapy and negative pressure therapy/ vacuum-assisted closure.

Research has determined that proteins which occur naturally in the body are integral in stimulating cell growth and migration necessary for wound healing. Growth factor therapy is based on this theory. Proteins are manufactured through recombinant DNA technology and applied to the wound as a daily topical treatment, in combination with comprehensive wound management.

Hyperbaric oxygen therapy increases the amount of oxygen in the patient’s blood, allowing oxygen to pass more easily through the plasma into the wounds to heal them. Hyperbaric medicine stimulates angiogenesis and fibroblast migration, enhances neutrophil and antibiotic killing action and suppresses alpha toxin production in gas gangrene. This particular therapy has proven beneficial in treating certain medical conditions, such as patients with diabetes who have wounds that are slow to heal; patients with wounds that haven’t shown improvement in four weeks; certain bone and skin infections; patients with radiation injuries and people with compromised or failing skin grafts or flaps.

Negative pressure therapy also called vacuum-assisted closure is a technique designed to promote the formation of granulation tissue in the wound bed either as an adjunct to surgical therapy or as an alternative to surgery in a debilitated patient. In this system, special foam dressing with an attached evacuation tube is inserted into the wound and covered with an adhesive drape in order to create an airtight seal. Negative pressure is then applied and the wound effluent is collected in a canister. It is hypothesized that negative pressure contributes to wound healing by removing excess interstitial fluid, increasing the vascularity of the wound and/or creating beneficial mechanical forces that draw the edges of the wound closer together.

The Wound Healing Center at Health Central affords a practical approach to wound care, while at the same time offering progressive treatment options to physicians and patients.



January 2008

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