The USC Center for Vascular Care collaborates with both the USC Wound Care Program and the USC Lymphedema Program. This alliance further enhances the continuity of care to our patients in providing a comprehensive treatment plan.
Physical Therapy Wound Management Services
Although physical therapy is most recognized for providing gait training and exercise to patients with movement impairments, the department at Keck Hospital of USC is also very involved in providing wound management to both in- and out-patients. Evidence-based interventions are used for a variety of wound diagnoses in order to facilitate healing, to improve patient function and self-care, and to improve quality of life.
Wound management begins with a thorough evaluation of the patient medical, history, social history, functional status (including strength, range of motion, and sensation), and complete wound assessment. Interventions are based upon standard care that has been established for the wound diagnosis (e.g. arterial, venous, pressure, or neuropathic) and the phase of healing (especially for surgical wounds). In the case of atypical wounds, the therapist works closely with the referring physician to identify factors that are contributing to or impeding wound healing.
Interventions provided by physical therapy may include any of the following: debridement (removal of devitalized tissue), biophysical technologies (electrical stimulation, pulsed lavage with suction, negative pressure wound therapy, MIST ultrasound), compression therapy, and dressing selection. Occasionally whirlpool therapy is indicated, which was the origin of physical therapy involvement in wound care! Patients with diabetes will also have shoe evaluation and adaptation, exercise, and gait training, as well as education on daily foot care. For patients with lower extremity wounds the ultimate goal is limb salvage, a goal that can only be met with meticulous foot care and active patient involvement.
The physical therapy wound management team is part of a multidisciplinary effort at Keck Medical Center at USC to provide comprehensive patient management to facilitate wound healing. The team works with physicians, nurses, dieticians, occupational therapists, case managers, social workers, and most importantly, patients and their families, to care for the total patient, not just the wound.
Team members include six physical therapists who have specialized training in wound management. Out-patients are seen on third floor of the hospital, and appointments can be made by calling 323-442-8850. A physician’s referral is required for any physical therapy evaluation and/or treatment.
Occupational Therapy Lymphedema Management Services
The Department of Occupational Therapy offers services at both the Keck Hospital of USC and Norris Cancer Hospital. This department provides in addition to routine occupational therapy, specialized areas of service in lymphedema and edema management. Five lymphedema certified therapists provide these services for in and outpatients.
The department specializes in managing primary and secondary lymphedema. The secondary lymphedema is acquired due to any general surgery, venous insufficiency, other vascular surgeries, overweight and morbid obesity, cancer and its treatments. Majority of lymphedema seen in clinic is secondary. This department also assists in reducing edemas of different kinds related to heart, liver and kidney failures. These are carefully treated in conjunction with other medical management.
After Physician’s orders are obtained, patient is scheduled for a complete assessment which comprises of physical, functional, psychosocial and cognitive needs of the client. The first step in the comprehensive program, the intensive phase, is established. This phase includes manual lymphatic drainage, meticulous skincare, multilayer compression bandaging, and remedial exercises/adaptations in life style. After maximum reduction of lymphedema, the patients are fitted with specially recommended compression garments. The patient is then discharged to a home program, which is important for the maintenance of lymphedema. The emphases of the treatment are to improve quality of life, and engagement in occupations of life.
In order to achieve successful outcomes, the Occupational Therapy Lymphedema team works closely with patients and their caregivers, and multidisciplinary team on an in and outpatient basis. The Department of Occupational Therapy outpatient services is located on the third floor of the Keck Hospital of USC. After a physician’s referral, appointments can be made by calling (323) 442-8850.
Non-Invasive Vascular Lab
The Noninvasive Vascular Laboratory performs sophisticated noninvasive cervical, cerebral, peripheral and abdominal vascular studies. The goal is to assist physicians in making a timely clinical diagnosis of venous or arterial circulatory conditions, while assisting them to determine the need for more complex diagnostic or therapeutic procedures.
The Keck School of Medicines Department of Medicine has created a new multi-disciplinary center designed to diagnose and treat hypertension, a chronic illness that affects as much as 25 percent of the U.S. population. Vito Campese, chief of nephrology and director of the new USC Hypertension Center, said the center is crucial because roughly 75 percent of Americans with hypertension do not receive appropriate treatment for it.
Vascular Rehabilitation Program
Patients with vascular disease involving the lower extremities can have significant pain when walking or exercising (claudication). The Vascular Rehabilitation program at USCUH is designed to increase patients' pain free walking distance and enhance their cardiopulmonary fitness. This treatment involves supervised intervals of exercise with the result of improving mobility and allowing the patient to increase the amount of activity in which they can be involved without pain.