A 62-year-old woman walked into my office carrying something most of my patients bring. Not just a wound, but years of disappointment.

She had been to hospital wound centers. She had done the treatments they recommended. She had shown up to every appointment, followed every instruction, and still, her wound would not heal. By the time she found us, she had stopped believing it could.

I hear this story more than you might think.

My name is Dr. Cyrus Garmo. I am board-certified in Internal Medicine and certified in Hyperbaric Medicine through ATMO, recognized by the Undersea and Hyperbaric Medical Society. At RevitalizeMe Hyperbaric Oxygen and Wound Care in Saginaw, Michigan, I run a dedicated outpatient center focused on one thing: healing wounds that have not responded to standard treatment.

If you or someone you love has a wound that won’t heal, this article is written for you. I want to explain why this happens, what most centers miss, and what a different approach can actually look like.

When a Wound Doesn’t Heal, the Problem Usually Isn’t the Wound

This is the part most people don’t hear from their doctor.

A chronic wound is a symptom. It is telling you something is wrong underneath the surface. The wound itself is not the disease. And if you only treat the wound without addressing what is driving it, you can dress it, debride it, and cover it every week for years. It still won’t heal.

I see this constantly. Patients come in with detailed wound care histories. They have had dressing changes twice a week for months. Some have had multiple debridements. Their wounds look slightly different from visit to visit, but they are not progressing. They are stuck.

The reason is almost always the same. Nobody has gone back far enough to ask why the wound isn’t healing in the first place.

There are several categories of root causes I look for. Vascular insufficiency is one of the most common. If the blood supply to the tissue is compromised, no wound dressing in the world will overcome that problem. Uncontrolled or poorly managed diabetes is another. Elevated blood sugar impairs virtually every phase of the healing process, from initial inflammation response to collagen production to immune function. Infection, including deep tissue infection that doesn’t always look obvious on the surface, is another major driver. So is nutritional deficiency, medication interactions, and in some patients, prior radiation damage to the tissue.

The wound is the result. Finding the cause is the job.

Why Hospital Wound Centers Often Fall Short

I want to be careful here because I have colleagues who work in hospital-based wound programs and they are good clinicians. The issue is not always the people. Often it is the structure.

Hospital wound centers operate on volume. They see a lot of patients. They run on protocols. The protocol for a venous ulcer looks like this. The protocol for a diabetic foot ulcer looks like that. You come in, the wound gets assessed, a dressing gets applied, you schedule your next appointment, and you leave. Two weeks later, the same thing happens.

That model works for wounds that are going to heal on their own with basic support. For wounds that are stuck, it doesn’t work.

The other limitation I see consistently is siloed care. The wound clinic is managing the wound, but nobody is talking directly to the vascular surgeon about flow studies. Nobody is digging into the patient’s hemoglobin A1c trends or having a real conversation about glycemic management. Nobody is considering whether hyperbaric oxygen therapy might be appropriate and getting that authorized before the wound becomes a crisis.

When you have a wound that isn’t healing, you need someone who is willing to look at the whole picture and coordinate every piece of it. That is a different model than most hospital outpatient programs are designed to deliver.

What a Dedicated Wound Care Center Does Differently

The difference comes down to focus and time.

At RevitalizeMe, wound care is not one service among thirty. It is what we do. Every patient who walks through our door has a wound that needs attention, and we have built our entire clinical model around that fact.

The first visit is longer than patients expect. We are not just looking at the wound. We are taking a full history, reviewing prior treatment records, assessing vascular status, looking at nutrition, reviewing medications, and talking to the patient about their daily life in a way that most busy wound clinics don’t have time to do.

From there, we build an individualized treatment plan. Not a protocol. A plan specific to that patient’s wound and the reasons it has not healed.

We also coordinate with referring physicians directly. If a patient needs a vascular surgery consult, we are not just giving them a phone number. We are communicating with that provider about the clinical picture and making sure that piece of the puzzle gets addressed in parallel with wound care, not after.

The other thing that sets a dedicated center apart is access to treatment modalities that most standard wound programs don’t offer. Hyperbaric oxygen therapy is the most significant of these for the right patients.

The Role of Hyperbaric Oxygen Therapy in Wound Healing

Hyperbaric oxygen therapy is one of the most misunderstood treatments in wound care.

Patients hear the word and they picture something experimental or futuristic. Referring physicians who trained before it became widely adopted sometimes still think of it as a last resort. Neither of those things is accurate anymore.

Hyperbaric oxygen therapy is FDA-approved and covered by Medicare and Medicaid for specific wound care indications. At our center, we use Sechrist hard-sided monoplace chambers. The patient breathes 100 percent oxygen at increased atmospheric pressure for typically 90 minutes per session. The result is a massive increase in the oxygen concentration delivered to the tissues, including tissues that are hypoxic from vascular disease, radiation damage, or infection.

Oxygen is not passive in wound healing. It is an active participant. It drives collagen synthesis. It supports angiogenesis, which is the formation of new blood vessels. It kills certain anaerobic bacteria. It reduces swelling. And in tissue that has been damaged by radiation, it stimulates the growth of new healthy vasculature into areas where the blood supply has been permanently compromised.

For diabetic foot ulcers that are Wagner Grade 3 or higher and have not responded to 30 days of standard wound care, hyperbaric oxygen therapy is a covered Medicare indication. The same is true for chronic refractory osteomyelitis, compromised skin grafts and flaps, and radiation injuries including osteoradionecrosis, radiation cystitis, and soft tissue radionecrosis.

I use HBOT for the right patients. It is not something we offer to everyone. But for patients where the clinical picture supports it, it can be the difference between a wound that finally heals and one that doesn’t.

What Root-Cause Wound Care Actually Looks Like

Let me tell you what happened with that 62-year-old patient.

When I reviewed her history, it was clear that her wound had been treated consistently but not comprehensively. Her blood sugar management was suboptimal. Her vascular status had not been formally evaluated despite a clinical picture that raised concerns. And she had never been assessed for hyperbaric oxygen therapy, even though her wound had been present for years and met criteria by almost every standard that exists.

We addressed each of those things in parallel. We got her connected with the appropriate vascular team. We worked with her primary care physician on tightening her glycemic control. We started a course of hyperbaric oxygen therapy alongside advanced wound care. And we changed the wound care plan itself based on what her wound was actually telling us, not a standard protocol.

Within two weeks, she called our office to say the wound looked different. Not healed. Different. For someone who had watched this wound do nothing for years, that was significant.

The wound healed. It took time and consistency, but it healed.

I am not telling you this to make a promise. Every patient is different and I cannot guarantee outcomes for anyone reading this article. What I can tell you is that the process we used with her is the same process we use with every patient. Start with why. Treat the whole picture. Use every appropriate tool available.

What You Can Expect at RevitalizeMe — From First Visit to Healed

Our center is located at 3200 Cabaret Trail S., Suite 3, Saginaw, Michigan. We are an outpatient facility, which means no hospital admission, no overnight stays, and a clinical environment that is specifically designed for wound care and hyperbaric treatment.

Your first visit will include a comprehensive wound and medical assessment. We will review everything you bring us. If you have prior records, imaging, or wound care notes from other providers, bring them. The more we know about what has already been tried, the faster we can identify what is still missing.

From there, we develop your treatment plan and walk you through it completely before anything starts. If hyperbaric oxygen therapy is part of the recommendation, we will explain the process in detail, answer your questions, and handle the insurance authorization.

We see patients with Medicare, Medicaid, and most major private insurance plans. We are actively credentialing with Tricare and the VA as well.

Our team includes our wound care nurse practitioner and certified hyperbaric specialist who work closely with me on every case. You are not going to see a different provider at every visit. You will know who is taking care of you and they will know your wound.

FAQ: Your Questions About Non-Healing Wounds Answered

How long does a wound have to not be healing before I should be concerned?

The general clinical threshold is four weeks without measurable progress. If your wound has been present for a month and is not showing signs of improvement, that is when a consultation with a wound specialist is appropriate. For wounds that have been present significantly longer, don’t wait.

Does insurance cover treatment at a wound care center?

Is hyperbaric oxygen therapy safe?

Yes, for patients who are appropriately evaluated and cleared. Like any medical treatment, there are contraindications we screen for before starting. Our center follows all FDA and safety guidelines for hyperbaric medicine. I am certified in hyperbaric medicine through ATMO and our hyperbaric specialist oversees all safety protocols.

Do I need a referral from my doctor to be seen at your center?

Not necessarily. You can call us directly and we will coordinate with your existing care team from there. If your physician wants to make a formal referral, we welcome that as well. Either way, we will communicate with your primary care provider and any specialists involved in your care.

What if I have already been to another wound center and it didn’t work?

That is one of the most common situations we see. Prior treatment at another center does not disqualify you from being seen here. In fact, knowing what has already been tried is useful information. Bring whatever records you have and we will start from there.

If you have a wound that has not healed despite treatment, I want to hear from you. Not because I can promise a specific outcome, but because in my experience, most non-healing wounds have a reason they are not healing, and most of those reasons can be found and addressed.

You have already been through a lot. Come in and let us take a real look.

— Dr. Cyrus Garmo, MD
Board-Certified Internal Medicine | Certified Hyperbaric Medicine, ATMO/UHMS