Vascular Surgery

Treating wounds that won’t heal

If you have a wound that hasn’t responded to conventional treatment or needs special care, the Center for Vascular, Wound Healing & Hyperbaric Medicine at Tufts Medical Center has innovative treatments that can help. The hallmark of our care is passion and compassion. We care about you and improving your quality of life. We are committed to providing you with the latest medical advances in wound care while working to improve your options through ground breaking research.

At the Wound Center, you will find comprehensive care along with the most advanced treatments available. We provide cutting edge hyperbaric oxygen therapy along with graft applications and compression therapy. You will also have access to the latest clinical trials including cellular therapy for non-reconstructable vascular disease.

The conditions treated here include:

• Diabetic foot wounds
• Venous stasis ulcers
• Arterial ulcers
• Surgical and pressure related wounds
• Osteomyelitis
• Radiation injury/necrosis
• Necrotizing infection
• Gangrene
• Pyroderma gangrenosum
• Calciphylaxis

You are at the center of our specialized team

The care in the Center for Vascular, Wound Healing & Hyperbaric Medicine is centered on what is best for the patient. We take an integrated approach that brings together specialists from several fields including vascular surgery, podiatry, infectious diseases, orthotics and physical medicine and rehabilitation. This allows us to better develop an individualized plan based on your needs and provide comprehensive care that addresses your wound along with other medical concerns. Because we are a part of the CardioVascular Center at Tufts Medical Center, you will have access to world-class resources including cutting-edge diagnostic and treatment options.

When you come to the center, we start with a thorough diagnostic evaluation that involves your current and ongoing care givers. For your convenience, we will obtain all the necessary medical records and keep your other care providers updated on your treatments and our recommendations for follow up care.

Following this evaluation, your team of specialists will work together to develop an ongoing care plan to treat your wound. At every step of the way, we will take the time to listen to you and to answer all your questions. Our comprehensive team approach achieves some of the best healing rates and fastest healing times in the nation. This means you can get back to your normal activity sooner and enjoy your life more without the pain of a chronic wound.

Healing your wounds with comprehensive care

Your individualized treatment plan will vary depending on the cause and current condition of your wound.  Effective wound care requires control over infection and bacterial overgrowth, removal of dead or compromised tissue, adequate circulation and ensuring that the wound is not subject to undue pressure. In addition we will address issues of appropriate nutrition, diabetic management and general heath.

Our team will assess each of these factors and provide a comprehensive and individualized treatment plan. During a clinic visit you will receive a directed history and physical exam, your medications will be reviewed and your wound will be examined, measured and photographed.

Next, we will provide appropriate wound treatment that might include washing and debridement. Finally, we’ll apply an appropriate dressing and help you arrange for your home wound care. When indicated, we will arrange for additional testing and consultation, much of which can occur right in our wound center. Since wound healing varies from person to person we will arrange for follow-up in our center to refine and adjust your treatment plan.

Hyperbaric oxygen therapy is an advanced technology that speeds healing and is often recommended for patients with hard to heal wounds that have not responded to more conventional treatments. It is effective for a range of conditions including wounds caused by diabetes, osteomyelitis or bone infections, radiation injury to bone or soft tissue, failed or compromised skin grafts or flaps and carbon monoxide poisoning.

Hyperbaric treatments are provided in a high-tech, clear cylinder that the patient lays in. This chamber is then filled with oxygen (100%) and the pressure is increased to about twice the normal atmospheric pressure.  Since normal air is 21% oxygen at atmospheric pressure, our treatment results in a 10-14 fold increase in the amount of oxygen you are exposed to during your treatment.

Exposure to this concentration of oxygen for a brief period results in many beneficial effects, including:

• Improving the delivery of oxygen to injured tissues
• Improving the ability of your white blood cells to fight infection
• Improving the ability of your body to move stem cells from your bone marrow to areas of tissue injury and therefore supports repair and replacement of your wound, infection or radiation injury

Treatments are scheduled Monday - Friday and are about two hours in duration. Typical treatment plans range from 6 to 12 weeks.

Once you are in the chamber, you will feel a breeze and hear the oxygen circulate. As the pressure gradually increases, you will feel a little warm and may experience a sensation of pressure in your ears or sinuses. This pressure is similar to the feeling you may have while traveling down a mountain, flying or scuba diving. A nurse or certified hyperbaric technician will remain with you during the treatment to monitor your body’s response and to coach you on how to relieve the pressure sensation you may feel in your ears.

Once the chamber is at the prescribed pressure, the fullness in your ears will cease and you may rest or sleep during the treatment. You may also watch television or listen to music. Near the end of your treatment, the nurse will gradually decrease the pressure. During this decompression phase, you may notice a “popping” sensation in your ears.

The number of sessions you will need depends on your condition and your body’s response to the chamber. We will consult with you throughout the process to make adjustments as needed. As a team, we work closely together to ensure that the hyperbaric oxygen therapy is integrated with other aspects of your treatment.

Learn more about hyperbaric oxygen treatments, what to expect, possible side effects and more >

Read the checklist to help you prepare for your hyperbaric oxygen treatment >

Tufts Medical Center is the lead site in a multicenter US trial investigating the use of cells extracted from a patient’s own bone marrow to treat patients with severe blockages of their leg arteries, who have foot or leg wounds and no suitable conventional treatment option.

It is hoped that by providing the body’s own stem cells and other cell types which support healing and growth of new blood vessels, to areas of most need, that the risk of amputation and the pain associated with critical limb ischemia may be relieved.

Biomet
A multicenter US clinical trial investigating the use of Bone marrow derive pluripotent cells extracted from a patient’s own bone marrow to treat patients with severe blockages of their leg arteries, who have foot or leg wounds or pain at rest cause by the poor circulation and no suitable conventional treatment options, ie. poor prospects for a bypass, stent, angioplasty, etc.  It is hoped that by providing the body’s own stem cells and other cell types which support healing and growth of new blood vessels, to areas of most need, that the risk of amputation and pain associated with critical limb ischemia may be relieved. This is a continued access trial meaning that all enrolled patients receive the study treatment.

Pluristem:
Similar to the aforementioned trial, the Pluristem clinical trial treats patients with severely blocked arteries and poor conventional options. In this study only patients with non healing ulcers related to the poor circulation are treated. This study utilizes placental stem cells that are injected into the affected limb in an effort to support healing and growth of new blood vessels, to areas of most need, in the hope of reducing a patient’s risks of amputation due to Critical Limb Ischemia. This trial has a placebo control arm meaning that not all enrolled patients will receive the active treatment. 

PuraPly:
PuraPly Antimicrobial Wound Matrix is a wound care product already on the market, FDA approved, and used weekly in our Wound Center at Tufts Medical Center. This product is used for the treatment and management of acute and chronic wounds through the use of collagen and an antimicrobial (PHMB). The RESPOND Registry is a multicenter effort to  track how this product is used in clinical practice  and to better understand the real world uses and outcome with this  product. 

3M:
3M has created a wound care product, the 3M Tegaderm Finishing Dressing, which is designed for use on wounds that are close to healing, but need extra help. This clinical trial aims to evaluate the safety and performance of this wound care product, with Tufts Medical Center as its first and only site. 

Aurix PRP:
Aurix is a platelet-rich plasma (PRP) gel used in the treatment of non-healing chronic wounds, specifically Diabetic Foot Ulcers, Pressure Ulcers, and Venous Leg Ulcers. The aim of this open label clinical trial is to demonstrate the effectiveness of complete wound healing in those three wound categories. Aurix uses a patient’s own PRP to create a gel that is directly placed on the wound bed, in hopes of stimulating stalled-healing in chronic wounds. 

When you refer your patients to us for wound care, we will work closely with you to ensure that they get the best care.  We will keep you informed about the care we are providing and our follow up recommendations. We strive to ensure that patients get the care they need in the most appropriate setting.

To refer a patient for Wound Care and Hyperbaric Oxygen Therapy call: 617-636-7761.

Hours of operation are Monday thru Friday 8am-4:30pm.  The Wound Specialist will work closely with referring physicians.

Center for Vascular, Wound Healing and Hyperbaric Medicine
Tufts Medical Center
800 Washington St.
Boston, MA 02111

We are located in the Rehabilitation Building, 1st Floor
185 Harrison Ave.
Boston, MA 02111
Call: 617-636-7761
Fax: 617-636-4235

Hours of Operation: Monday thru Friday 8am-4:30pm.