Wound Care Center
Chronic wounds and wound problems present a major challenge, as they:
- occur at any age - from newborns to the elderly
- are constantly increasing in medical and economic importance due to:
- better care for premature babies
- better trauma management
- better tumor management
- increasing number of diabetic patients
- increasing age pyramid
- not only affects the patient, but also those (family, …) around them
Overview
- “The Patient, not the wound alone”
Especially in chronic wounds, it is always important not to see the wound as an isolated local problem (local wound healing), but also as a systemic problem (general condition of the patient/systemic wound healing)
- Multidisciplinary Approach: Due to the large number and diversity of Chronic wounds, Problem wounds, and Tumor wounds it is clear that a single discipline or specialty alone is not able to treat all wounds.
- Core Group: Patients are initially seen by Dermatology (→ Link Dermatology), Plastic Surgery (→ Link Plastic Surgery), General Surgery (→ Link General Surgery, or Vascular Surgery (→ Link Vascular Surgery)
- Multidisciplinary Wound Care Team: Depending on the initial Wound examination, further specialties are consulted for individually tailored diagnostic and treatment
- The Wound Care Center is a multidisciplinary cooperation for the care of patients with chronic wounds and problem wounds. It is a national and international reference center for comprehensive Wound Care, for Muscat and Oman.
- Bord-certified, famous doctors: Due to broad training in national and international leading centers and many years of experience, our famous, board-certified doctors offer the full range of “state of the art” wound care at the highest level
- “all under one roof”: Fakeeh University Hospital Dubai is proud to offer all necessary diagnostic and treatment options by nationally and internationally known experts
- From Hospital (Wound Care center) to Home (Wound Care Network)
| Hospital Care: | The best wound care in the hospital (Wound Care Center) is only short-lived if it cannot be continued after discharge from the hospital at home |
| Hospital-to-Home Transition: | A standardized wound care transition from hospital-to-home is of crucial importance. |
| Home Care: | Most chronic wounds and problem wounds can be successfully treated by outpatient treatment (GP + Outpatient Nursing Service): Only a complete continuation of the treatment started in the hospital, at home, guarantees the sustainability of the treatment success. We specifically seek contact with the GP and the outpatient nursing service, as they often know the patient and their living conditions best. |
| Home-to-Hospital Transition: | In the event of a significant deterioration in the wound condition, which cannot be improved despite changes in the outpatient care measures, rapid admission to the hospital is necessary in order to avoid further harm to the patient. |
Scope of Medical Care
Chronic wounds and problem wounds have different causes, such as infection, poor blood supply, pressure, trauma, tumor, etc….. From a clinical view it is very useful to distinguish the following:
Diabetic Foot Syndrome
The term diabetic foot (diabetic foot syndrome, DFS) describes a complication that can occur with long-term diabetes. The impairment of blood circulation (diabetic angiopathy) and the feeling (diabetic polyneuropathy) leads to unnoticed pressure points, which can then cause open wounds. Wounds are not treated early and do not heal quickly, but enlarge. They can also be infected by germs.
A multidisciplinary, multiprofessional approach has proven itself for the diagnosis and treatment of diabetic foot syndrome.
Close cooperation between Nursing (Prevention), Endocrinology/Diabetology, Neurology, Angiology/Vascular Surgery, and Hyperbaric Oxygen Therapy is mandatory.
Pressure Sores/Decubitus
The development of a pressure sore has many reasons. There are a number of external (environment) and intrinsic (patient) risk factors that favor the occurrence of decubitus ulcers:
- Extrinsic risk factors such as pressure, friction or moisture act from the outside and are of outstanding importance in prophylaxis.
- Intrinsic risk factors, such as reduced spontaneous mobility, reduced protective sensitivity, skeletal deformities or arterial occlusive diseases are patient-related and usually have to be considered as given
To classify a pressure sore defect the following criteria should be specified;
- localization
- size/volume
- Depth extent (EPUAP classification)
- Condition of the wound (classification according to Seiler)
- Etiology
Diagnosis and therapy of decubitus is carried out by a multidisciplinary treatment team with a common language for diagnosis and documentation and a so-called "integrative therapy concept", which is based on:
Avoidance/prevention of decubitus
The best treatment for pressure ulcers is to avoid them (prevention). The following principles have proven themselves:
- Pressure ulcer risk assessment using scores/scales
- skin care
- Elimination or reduction of risk factors
- Guidance on personal hygiene
- Consistent therapy of contractures
- Optimization of nutrition
- Guidance on self-reliance
Control
The Decubitus Evaluation System (DES) has proven itself for standardized control and standardized documentation
Decubitus therapy
If there is a manifest decubitus, this first means that the measures to avoid it (prevention) were not sufficient. Decubitus therapy is based on:
- Systemic therapy
- Optional additional therapy
- Local therapy
A multidisciplinary, multiprofessional approach has proven itself for the diagnosis and treatment of pressure sores.
Close cooperation between Nursing (Prevention), Dermatology and Plastic Surgery is mandatory.
Lower Leg Ulcer
A leg ulcer (leg ulcer) is a deep and usually poorly healing wound on the lower leg
Lower leg ulcers are skin lesions that result from poor blood flow in the:
- Veins (Varicosis) → venous leg ulcers
- Arteries (Angiopathy) → arterial leg ulcers
- Arteries and veines → mixed leg ulcers
A multidisciplinary, multiprofessional approach has proven itself for the diagnosis and treatment of lower leg ulcers.
Close cooperation between Dermatology, Angiology/Vascular Surgery, and Hyperbaric Oxygen Therapy is mandatory.
venous Leg Ulcer
This by far the most common form of "leg sore" is based on disturbed venous blood flow, more precisely chronic venous weakness (chronic venous insufficiency
They affect 1 in 100 people, mostly women, and up to 3% of those over 65. These ulcers take a long time to heal. And they must be taken very seriously once they occur to prevent them from getting worse
Such ulcers form primarily in the lower area of the lower leg. They are usually very extensive
In most cases, an attempt is first made to improve blood flow with compressive bandages. These increase the pressure in the vessels and ensure that the blood flows faster again. These bandages can be applied regularly by a doctor or a physician assistant. The patient himself can also do this as soon as he has learned how to do it.
In addition, people with a leg ulcer should move a lot. This also stimulates the blood flow and prevents the blood from stagnation.
Arterial (ischemic) Leg Ulcer
Arterial ulcers, also known as Ischemic ulcers or Ischemic wounds, are commonly caused by peripheral artery disease (PAD). The arteries are responsible for carrying nutrient- and oxygen-rich blood to the various tissues in the body.
Ischemia, which refers generally to a restriction in the blood supply, can lead to arterial ulcers when it stems from a narrowing of the artery or damage to the small blood vessels in the extremities
The reduced blood flow then in turn leads to tissue necrosis and/or ulceration
Unlike other ulcers, these leg wounds can take months to heal, if they heal at all. To treat arterial ulcers, your doctor will try to restore blood circulation to the affected area
Mixed (venous & arterial) Leg Ulcer
Doctors speak of this when a "spread leg" is caused by a simultaneous narrowing of both blood circulation systems - the venous and the arterial vascular system.
Burns
The term “ Burn wounds” refers to wounds, that are primarily caused by:
- Heat (thermal burns)
- hot liquids (scalds)
- hot solids (contact burns)
- flames (flame burns)
- Radiation
- Radioactivity
- Electricity
- Friction
- contact with chemicals
Burn injuries can affect any tissue.
Most burn injuries occur in the skin area. Depending on the amount of energy released and local factors (blood circulation in the skin, thickness of the skin, ...) the skin is damaged to varying degrees of depth:
The deeper the burn injury, the less pain
Procedures
The classic treatment sequence for burn injuries is:
- First Aid for Burns (Emergency Treatment)
- Specific burn Treatment
- Specific Burn Rehabilitation (Scar Management)
First Aid for Burns (Emergency treatment)
Cooling:
- Burn should be cooled with cool or lukewarm running water for 20 minutes. Never use ice, iced water, coffee, or any creams or greasy substances like butter on a burn
- The sooner a burn is cooled the less the impact of the injury.
- Cooling the burn will reduce pain and swelling
Covering:
After the burn has been cooled, cover it with cling film or a clean plastic bag. This helps prevent infection by keeping the area clean. Never use any creams as they may impair the diagnosis
Transfer to spezialized doctor:
Diagnosis and treatment of burn problem wounds is carried out by a multidisciplinary treatment team, which guarantees that the respective discipline with the specific expertise takes over the treatment. This team is lead by a doctor trained in burn wound treatment (Plastic surgeon).
Specific Burn Treatment
Depending on the depth of the burn, conservative (non-surgical) or surgical treatment methods are used.
Closed blisters should always be left in place and not opened, as these provide the best sterile dressing
Specific Burn Rehabilitation (Scar Management)
Higher degree burn injuries (> IIa) always lead to extensive scar areas
Early and consistent scar suppression therapy must always be started immediately after complete wound closure in order to effectively avoid additional secondary damage (contractures)
Problem Wounds
The term “Problem wounds” refers to wounds, that needs special, standardized treatment, by different specialities.
When problem wounds are not well identified, their treatment by an inexperienced treatment team results in:
- Prolonged treatment duration with significant impairment of the patient
- Poor treatment outcome
- Increased complication rate, including permanent damage
- Skin tears (→ Plastic Surgery)
- Degloving (decollement) injuries (→ Plastic Surgery, Orthopedics)
- Extravasation injuries (→ Oncology, Plastic Surgery)
- Hiddradenitis suppurative (Acne inversa) (→ Dermatology, Plastic Surgery)
- Contractures and Scars (→ Plastic Surgery)
- Chronic skin diseases (→ Dermatology)
- Calciphylaxis (→ Nephrology)
- Chronic Osteomyelitis (→ Orthopedics)
- Thoracic Stoma (→ ENT, Thoracic surgery)
- Stoma (→ General Surgery)
- Open Abdomen (→ General Surgery)
Tumor Wounds
The term “Tumor wounds” refers to any wounds, that occur in the course of tumor treatment
Exulcerating Tumor wounds may lead to severe impairment of the patient caused by
- non-healing wound (early symptome)
- Bleeding
- Pain
- Secretion
- Bad Smell (odor)
- Impairment of surrounding normal skin due to dressing
If tumor wound resection is not possible for any reason, the following requirements for the wound dressing must be taken into consideration:
- Mechanical protection of the wound
- No adhesion of the dressing with the wound (fat gauze, ….)
- Minimal discomfort/pain cause by dressing
- Adequate wound secretion management
- Adequate wound smell management
- Minimal irritation of the surrounding skin
Tissue defects after tumor resection
Whenever possible a complete tumor (R0) resection must be carried out. A histological control of the margins and the bottom of the resected tumor (wound) is always necessary.
The resulting defect must be covered as soon as possible.Even ín the reconstruction of disfiguring tumors or life-threatening large defects, the plastic surgeon always strive for the best available aesthetic result in addition to restoring the function – „form is function“-.
Adequat defect reconstruction after tumor resection determines:
- Possibilities of postoperative adjuvant treatment
- Quality of life
Tissue defects after tumor resection
Multimodal tumor treatment is now the gold standard. However, every form of therapy also has possible complications. Early and adequate management of complication cause by the tumor treatment itself is mandatory for
- Possibilities of adjuvant treatments
- Quality of life
| Surgery: |
Tissue loss after surgery (wound necrosis) Chronic lymphedema after tumor surgery (Resection of lymph nodes/Lymphadenectomy) |
| Chemotherapy: | Extravasation of Chemotherapy (peripheral and/or port-A-Cath) |
| Radiotherapy: | Early and late actinic tissue changes |
Health Education
“Wound Care begin with awareness”
What is normal Wound healing?
What is more important, the wound or the patient?
What is impaired wound healing?
What are the reason for impaired wound healing?
………..
…….and to know what is typical for you
Being familiar with how you usually look like and feel makes it easier to detect when there's a change
At the Health Education Center, we are empowering patients, their families and the community to take control of their Body & Soul, by providing important information on
- Wellness
- Health
- Beauty
- Longevity
Neem Health Education Center is dedicated to going beyond traditional education, fostering continuous learning through various platforms.
Our Experts
The Wound Care Center is a multidisciplinary cooperation for the care of chronic wounds and problem wounds
Updates
| 06.2025 | Announcing hospital services through targeted Digital Ad campaigns |
| 07.2025 | Open-door day |
| 07.2025 | Opening of the Wound Care Center at Neem Hospital |
Check-in at Neem Hospital
Neem Hospital has a transparent organizational structure: Although there is a clear top-down organization, we encorage and support every individual employee idea that can contribute in this direction. Our leaders are open to feedback, they take action on feedback, we arrange regular Town Hall sessions, and also an Annual Employee Engagement Survey.
As a campany culture, we strive in areas such as:
- seamless healthcare services
- holistic care of body & soul
- value-based care
- Education
- Prevention
- Care with Technology
At Neem Hospital Hospital, we engage in several engagement activities that support the well-being of our employees and recognize the valuable contributions of the team. To ensure this, we have a comprehensive rewards and recognition program.
We believe in celebrating:
- Respect
- diversity and cultures
- family involvement activities like Movie Time, Festive celebrations with employees and their families
Neem Hospital is the perfect combination of futuristic ideas and Omani traditions, culture and values (“where tradition meets future”)
