Wound care / Limb salvage

About the procedure

As the US population ages and the number of people with diabetes increases, patients with chronic wounds are becoming more common among the US population. These wounds are difficult to care for, and often require a multidisciplinary group of healthcare providers including nursing, plastic surgery, vascular surgery, orthopedic surgery, podiatry, and general medical doctors as well as infectious disease doctors.

The first step that Dr. Hirsch will perform in the treatment of a chronic wound is a thorough evaluation of the general medical condition of the patient, and treatment of modifiable risk factors. For example, in patients who are diabetics, tight control of blood glucose levels will help aid healing. Adequate nutrition, treatment of bone and soft tissue infection, and optimization of blood flow are all critical in the early assessment of chronic wounds. At the same time, Dr. Hirsch will remove devitalized tissues and clean wounds in order to reduce bacterial levels and aid healing. Finally, smoking cessation is critical before any reconstructive efforts can be undertaken.

After the patient is medically optimized for wound reconstruction, Dr. Hirsch will use a variety of techniques to repair the wound. Skin grafts, local skin flaps, muscle flaps, and free microvascular flaps are all options that Dr. Hirsch uses to reconstruct chronic wounds. Dr. Hirsch tailors his treatment plan to the presentation of each individual patient, and he will discuss the plan at the time of the consultation.

Frequently asked questions about wound care/limb salvage:

What type of wounds does Dr. Hirsch treat?

Dr. Hirsch will evaluate any wound, including lower extremity wounds, diabetic foot ulcers, chronic bone infections, pressure sores, non-healing traumatic wounds, wounds of the head and neck, and venous stasis ulcers. If you have a chronic wound and it is not healing, Dr. Hirsch will be happy to evaluate your wound and help guide your treatment.

Does Dr. Hirsch work with any local wound care centers?

Dr. Hirsch believes that a multidisciplinary approach for chronic wound care is important to aid healing. He works with wound care teams at Providence Tarzana Medical Center as well as at the Amputation Prevention Center at Sherman Oaks Hospital.