Hospital Risk Share

Complex Healthcare will provide hospital based programs the opportunity to Share Risk with us

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Joint Ventures

Complex Healthcare welcomes the opportunity to work with physicians and physician groups

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Revenue Cycle Management

Complex Healthcare has a growing staff of professional billers, coders, and collection personnel.

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Safe-D-Net

Complex Healthcare helps fill the voids in your Wound Care programs..

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Compromised Skin Flaps or Grafts

Skin grafts and flaps are used to cover large wounds. Hyperbaric oxygen therapy can help grafts and flaps heal when they are not getting enough blood flow and oxygen and have become compromised. During hyperbaric oxygen therapy, you breathe pressurized oxygen while you lie inside a clear plastic tube. The extra oxygen helps your body repair damaged tissue and fight infection. Each treatment can take up to 2 hours. Side effects from the treatment are rare.

How Is a Failed or Compromised Skin Graft Diagnosed?

There are many reasons that grafts can fail. Scrupulous surveillance of a graft includes serial inspection of both the donor site (in autografts) and the graft (recipient) site. Such surveillance is necessary to diagnose any processes that may contribute to a graft’s failure:

  • Poor vascularity.

Vascular compromise can be diagnosed by inspection for color change, diminished capillary refill, temperature, edema, and general appearance.

  • Hematoma or seroma, i.e., collections of blood or fluid, respectively.

Blood or transudate (exudate, in the case of infection) can be diagnosed via aspiration with a needle. The retrieved contents are examined microscopically for red blood cells, white blood cells, and bacteria (via a gram stain). The aspirate also can be cultured for sensitivity testing of any positive bacterial growth. Aspiration also allows the therapeutic benefit of reducing separation between the graft and the wound bed.

  • Infection of graft site.

The most common infectious organisms are methicillin-resistant Staphylococcus aureus (MRSA), Streptococcus, or Pseudomonas.

If infection is suspected, diagnosis is via cultures from the graft site,  retrieved to identify any infecting organism with subsequent testing for its sensitivities to several antibiotics.

  • Mechanical shearing.

The most common cause of graft failure is movement, which dissociates any new blood vessel growth (neovascularization) into the graft, depriving it of oxygen and nutrients. This complication causes fluid collection between the graft and the graft site bed (hematoma or seroma), further separating the graft from the bed. Immobilization is accomplished by appropriately dressing the graft site.

Prevention of Failed or Compromised Skin Graft

Preventing graft failure or compromise is by scrupulous surveillance to identify as early as possible the following:

  • Poor vascularity
  • Hematoma or seroma
  • Infection
  • Mechanical shearing

Pre-graft, these complications can be prevented by proper wound bed  preparation. During the grafting, complications can be reduced with intraoperative meticulous hemostasis and careful placement of the graft. After the procedure, immobilization is used with appropriate dressing to prevent shearing during the healing period.

Comorbidities that negatively impact neovascularization and healing should be addressed before the procedure to give the graft the best opportunity to “take” (proper adhesion) and the site to heal. This entails strict glycemic control for diabetics, smoking cessation, and correcting any protein or vitamin deficiencies. Medications that interfere with wound healing (steroids, immunosuppressants, and anticoagulants) should be discontinued temporarily.

In full-thickness skin grafts, the wound should be debrided where necessary and inspected for shearing or infection. Any fluid collections should be drained via creating small perforations and aspiration, which has the added benefit of diagnosing infection via retrieval of material to culture.

After about 2 weeks, the epithelium of a skin graft should be intact and scar prevention measures begin.  Silicone covering and pressure therapy are

Ready for an appointment?

At Complex Healthcare Solutions, our care team’s approach is to collaborate with your treatment to address any existing conditions you are currently suffering. Our specialists will work to create a complete treatment plan suited to you to heal and fully recover quickly.

To make an appointment with our healthcare professional and specialists, submit your appointment request or call us at +1-817-386-8886.

Compromised Skin Flaps or Grafts

Skin grafts and flaps are used to cover large wounds. Hyperbaric oxygen therapy can help grafts and flaps heal when they are not getting enough blood flow and oxygen and have become compromised. During hyperbaric oxygen therapy, you breathe pressurized oxygen while you lie inside a clear plastic tube. The extra oxygen helps your body repair damaged tissue and fight infection. Each treatment can take up to 2 hours. Side effects from the treatment are rare.

There are many reasons that grafts can fail. Scrupulous surveillance of a graft includes serial inspection of both the donor site (in autografts) and the graft (recipient) site. Such surveillance is necessary to diagnose any processes that may contribute to a graft’s failure:

  • Poor vascularity.

Vascular compromise can be diagnosed by inspection for color change, diminished capillary refill, temperature, edema, and general appearance.

  • Hematoma or seroma, i.e., collections of blood or fluid, respectively.

Blood or transudate (exudate, in the case of infection) can be diagnosed via aspiration with a needle. The retrieved contents are examined microscopically for red blood cells, white blood cells, and bacteria (via a gram stain). The aspirate also can be cultured for sensitivity testing of any positive bacterial growth. Aspiration also allows the therapeutic benefit of reducing separation between the graft and the wound bed.

  • Infection of graft site.

The most common infectious organisms are methicillin-resistant Staphylococcus aureus (MRSA), Streptococcus, or Pseudomonas.

If infection is suspected, diagnosis is via cultures from the graft site,  retrieved to identify any infecting organism with subsequent testing for its sensitivities to several antibiotics.

  • Mechanical shearing.

The most common cause of graft failure is movement, which dissociates any new blood vessel growth (neovascularization) into the graft, depriving it of oxygen and nutrients. This complication causes fluid collection between the graft and the graft site bed (hematoma or seroma), further separating the graft from the bed. Immobilization is accomplished by appropriately dressing the graft site.

Preventing graft failure or compromise is by scrupulous surveillance to identify as early as possible the following:

  • Poor vascularity
  • Hematoma or seroma
  • Infection
  • Mechanical shearing

Pre-graft, these complications can be prevented by proper wound bed  preparation. During the grafting, complications can be reduced with intraoperative meticulous hemostasis and careful placement of the graft. After the procedure, immobilization is used with appropriate dressing to prevent shearing during the healing period.

Comorbidities that negatively impact neovascularization and healing should be addressed before the procedure to give the graft the best opportunity to “take” (proper adhesion) and the site to heal. This entails strict glycemic control for diabetics, smoking cessation, and correcting any protein or vitamin deficiencies. Medications that interfere with wound healing (steroids, immunosuppressants, and anticoagulants) should be discontinued temporarily.

In full-thickness skin grafts, the wound should be debrided where necessary and inspected for shearing or infection. Any fluid collections should be drained via creating small perforations and aspiration, which has the added benefit of diagnosing infection via retrieval of material to culture.

After about 2 weeks, the epithelium of a skin graft should be intact and scar prevention measures begin.  Silicone covering and pressure therapy are

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