Dr. John Jackalone, Medical Director at the Center for Hyperbaric Medicine & Wound Healing at Mercy Hospital and Co-Medical Director at the Center for Hyperbaric Medicine & Wound Healing at St. Joseph Hospital
Why are you passionate about wound healing?
I’ve been practicing wound care for over 20 years. The biggest thing for me about wound healing as a doctor is that you get to visually watch these wounds resolve. It’s not like giving someone a prescription for medication or asking them how they’re feeling. You can actually watch the results of what you’re doing come to fruition. You can see the patient regain their mobility, regain their freedom, go back to work or start to play with their grandchildren again. So to me it’s very palpable. It’s a very real result and I find it very satisfying to be able to give someone back their lifestyle and know that I’ve had a hand in doing that.
Why do you feel that wound care is essential?
People may look at a wound on someone’s foot and say it’s just a tiny little opening or look at a wound that someone has on their back or on their heel and ask what is the big deal. The reality is that these wounds really alter someone’s life.
They may have to wear special shoes and decrease their activity. They may not be able to go to work or play with their grandchildren. The wound being open is like renting a cabin in the woods and leaving the back door open—the longer it’s open, the more chance there is of bacteria getting in and the patient getting an infection.
Patients can, in some cases, develop sepsis and lose their lives over something that looks like a tiny opening. But any opening is a way for bacteria to invade a patient’s body. Now this wound that was just a problem on the bottom of their foot has now become a threat to their overall well-being and even their life. We have a funny saying—you don’t treat the hole in the patient, you treat the whole patient. So it’s really important and you really get to see how profound of a difference it makes for them when you shake their hand and tell them you’re healed, you can go back to work and you can resume your normal activities.
These patients usually also have comorbidities/other medical problems. They may not be able to exercise and may gain weight. Their blood pressure may go up and their blood sugar may go up. They may also have a heart condition where they’re supposed to be walking a certain amount to get their heart rate up and they can’t do that because walking or any other activity would have a negative effect on their wound. So in many cases that open wound is really affecting their overall health because they’re unable to be active and manage their other health issues.
When is it necessary to go to a wound care treatment center?
A lot of people ask when a wound is ready for a wound care center. I would say all of us throughout our lives have hurt ourselves at one point or another like shaving, skinning a knee or while cooking in the kitchen. if you have a wound that is taking longer to heal than it would have five years ago, two years ago or 10 years ago, you should probably seek the opinion of wound specialist.
The worst that could happen is that we’ll look at it and tell you that the wound is actually healing nicely, it’s where it needs to be and you’re doing everything right. In that case, you go home with peace of mind and we’re not bothered at all that you’ve decided to bring that wound in to see us because we want to make sure that it’s not a problem. The earlier in the process that we get to see the wound, the easier that it is to close the wound.
I don’t like to put six weeks, four weeks, 12 weeks, 10 days. I like to say to the patient if you think that something is not healing right, it doesn’t look right or it’s taking longer than you think it should, then by all means come in and let a dedicated wound professional take a look at it and determine if there are any issues that need to be treated.
What’s special about a wound care center is that all the tools that we need are in the center—from diagnostic tools to wound care products and things that we use to treat the wound.
The other thing is that being in a hospital, like where our wound care centers are located, you have access to a bone scan, an MRI, a blood culture, blood flow testing, an X-ray or a CT scan. You can also be seen by the Diabetes Education Center and physical therapy department or be sent to the emergency room if needed.
It really does impact the outcome when you’re able to get all of the pieces of the puzzle together to begin treatment. If you begin treatment without all of the knowledge in front of you then you might not chase down something that you need to chase down. And you have a wound that doesn’t want to heal because of an unknown issue.
What sets your center apart from other wound care centers?
It’s our staff who take care of patients. The nurses and doctors and support staff who I work really do carry out the mission of Catholic Health. We’re dedicated to making patients whole again.
How would your team describe you?
I like to take my time to explain to patients what they have, why they have it, what I want to do for them and why that’s going to be important. I think that when you’re working with patients in the wound care center, it’s probably not their first visit to a doctor. They likely have issues like diabetes or vascular issues. So they are used to being told don’t eat this, don’t drink that, don’t go here or don’t go there. If you give people rules without explaining to them why they need to follow those rules then they don’t want to follow them and they probably won’t follow them. That’s going to impact the outcome.
So I make education the most important part of my interaction with the patient. Because if I tell you and explain to you why you should do something, and how it impacts your healing, then I haven’t given you another rule you don’t want to follow. I’ve educated you and now you understand it.
What types of patients will benefit the most from your type of expertise?
Really anyone with a chronic wound. It’s hard to say what type of patient because every patient comes with a different wound in a different spot. And every patient comes with a completely different set of complicating circumstances. Yes, a lot of the patients who we see have diabetes related wounds and circulation issues. But we also see patients with wounds from a surgery, a skin condition, an autoimmune disease or skin cancer that didn't heal. We also see patients who have skin damage or internal damage from radiation therapy for cancer. There really is an entire gambit of patients who benefit from the care and expertise of a wound center.
Are there any success stories that stand out to you?
We have many situations where patients were scheduled for life-altering amputations and we were able to save that limb and affect a tremendous change in their life. Those stories stand out to me. We have a greater than 90 percent limb salvage rate. These patients are very sick and have a lot of issues. So we’re very proud of that number.