Hyperbaric chambers give doctor a leg up on healing wounds

Dr. Regina Phillips and program director Karen Treadwell demonstrate how patients enter a hyperbaric chamber at Russell Medical’s Wound Care Center.

(Jimmy Wigfield / The Outlook)

For diabetics and others with slow-to-heal wounds, Russell Medical’s Wound Care and Hyperbaric Medicine Department has proven to be a nearly foolproof solution.

“We’ve saved a lot of legs and a lot of toes,” said Dr. Regina Phillips, the physician in charge of the department. “Our success rate is in the mid to high 90s. We joke that we’re not only saving a limb but lives because through our process we’ve found people with cancer and blocked arteries.”

Diabetic patients are often unaware they are developing foot sores because the chronic disease can lead to neuropathy and numb the sensitivity of the body’s extremities. Russell Medical’s twin hyperbaric chambers, which enclose a patient in 100 percent oxygen, boost the body’s natural healing process.

“The chamber is the gold standard for treating diabetic wounds,” Phillips said. “When you breathe oxygen under pressure, that large amount of oxygen is diluted into your blood and it carries an enormous amount of oxygen to areas that need them. It stimulates the bone marrow to release stem cells, which will go to the wound and turn into new tissue and blood vessels. It also kills bacteria in bone infections.”

The two hyperbaric chambers in Alexander City help patients avoid a trip to Birmingham or Montgomery, the next closest sites for treatment.

While some patients are uncomfortable being sealed inside a clear tube for two hours at a time, Phillips said most find it comfortable, even relaxing.

“It’s warm,” she said. “You can watch TV.”

Others are hesitant about lying in such close quarters.

“I’ve had people go in and say, ‘You’ve got to get me out,’” Phillips said. “I had one refuse to go back in. Some people have confinement anxiety in the chamber. Typically after one or two treatments they’re fine. Some can be given something to help them relax.”

The patients are serene a majority of the time.

“A technician is always with them,” Phillips said. “I’ll go to check on them and the tech will say, ‘He’s sound asleep.’”

There is a fire risk to the chamber because 100 percent oxygen is highly flammable. When exposed to a spark, an inferno such as the one that killed the Apollo 1 astronauts during a launch-pad test in 1967 can result.

“In the chamber you must wear 100 percent cotton due to the fire risk of the pure oxygen,” Phillips said. “If you weren’t born with it, you can’t take it in. We don’t want anything that might spark.”

Phillips said patients who are treated in the hyperbaric chamber must come Monday through Friday for two hours each session.

“That’s 40 to 60 treatments over eight to 12 weeks,” she said. “It’s a big commitment but we see almost everybody complete their treatment here.”

That is gratifying to Phillips, who knows amputation can often cripple patients emotionally.

“If you lose a leg to a wound, you lose your freedom, especially if you’re older,” she said. “Maybe you’re not strong enough to use that crutch or that wheelchair. I’m passionate about it because of how much it means to have both legs. If you don’t, your life expectancy goes down considerably.”

Russell Medical’s facility has succeeded so well with wound care it received Healogics’ 2018 Dr. Robert A. Warriner III Center of Excellence award for achieving patient satisfaction rates higher than 92 percent and a healing rate exceeding 91 percent in less than 30 median days to heal for three consecutive years. Warriner is a pioneer in wound care.

Phillips said patients must meet stringent criteria to be treated in the hyperbaric chamber.

“Not all diabetics can go in,” she said. “If the wound is not badly infected or it’s a bone infection, it wouldn’t qualify. If they have chronic refractory osteomyelitis or they’ve tried IV antibiotics, that can put you in the chamber, or crush injuries, interstitial cystitis, spider bites, dog bites, rattlesnake bites, anything toxic that can cause tissue damage.

“Medicaid won’t pay for arterial inefficiency. You have to revascularize them. If you have an embolus in the leg in an artery, not a blood clot in a vein, you’d qualify for the chamber. Soft tissue radio necrosis, which is an injury to tissue with radiation, if you have that six months after the last radiation treatment, that would qualify.”

Phillips, who was born and raised in Demopolis, graduated from the University of Alabama Medical School in Birmingham and spent three years in physical medicine and rehabilitation at Emory University Hospital in Atlanta. During her residency, she worked with Dr. Phala Helm, whom she called “the foot guru.”

“I’ve treated wounds all my career,” Phillips said. “As I get older, what I really, really love is working with wounds of geriatric patients.”

Phillips said she came to Alexander City because of Russell Medical’s affiliation with Healogics.

“They’re the largest wound care company in the U.S. and they do it better than anybody,” she said. “I wanted to work with them and stay in Alabama. There was an opening here at Russell and what better place to live than on the lake?”