Comprehensive Wound Care Services in San Antonio, Texas
Hill Country Wound Care and Hyperbarics provides physician-led advanced wound care services at three locations serving Greater San Antonio: Bulverde (32357 US 281, Bulverde, TX 78163), Live Oak (12215 Toepperwein Road, Live Oak, TX 78233), and Southwest San Antonio (7127 Somerset Rd, San Antonio, TX 78211). Our board-certified wound care and hyperbaric physicians specialize in treating diabetic foot ulcers, venous leg ulcers, pressure injuries, arterial ulcers, surgical wounds, radiation injuries (osteoradionecrosis), osteomyelitis, and traumatic wounds using evidence-based therapies tailored to each patient's specific wound type and healing needs.
Advanced Wound Care Therapies
Our comprehensive service offerings include hyperbaric oxygen therapy (HBOT) for Wagner Grade 3+ diabetic ulcers and radiation tissue injuries; sharp debridement (CPT codes 11042-11047) to remove necrotic tissue and biofilm; advanced wound dressings including foam, hydrocolloid, alginate, hydrogel, and antimicrobial options; negative pressure wound therapy (NPWT/wound VAC, CPT codes 97605-97606) to reduce edema and stimulate granulation; platelet-rich plasma (PRP) therapy delivering autologous growth factors to stimulate tissue regeneration; cellular tissue products (skin substitutes, CPT codes 15271-15278) including amniotic membrane allografts and bioengineered skin; ultrasonic mist therapy using low-frequency ultrasound to disrupt biofilm; and compression therapy for venous insufficiency ulcers and lymphedema management.
Hyperbaric Oxygen Therapy (HBOT)
Our FDA-cleared hyperbaric oxygen therapy program treats qualifying conditions including Wagner Grade 3 or higher diabetic foot ulcers that have failed standard wound care for 30 days, radiation tissue injuries (osteoradionecrosis, soft tissue radionecrosis), compromised skin grafts and flaps, acute traumatic ischemia, and osteomyelitis refractory to standard treatment. Patients breathe 100% oxygen at 2.0-2.5 ATA (atmospheres absolute) for 90-120 minutes per session, typically completing 20-40 sessions over 4-8 weeks. HBOT increases dissolved oxygen in plasma 10-15 times normal levels, reaching ischemic tissue where red blood cells cannot pass, promoting angiogenesis, enhancing bacterial killing, reducing inflammation, and stimulating fibroblast activity for collagen production.
Debridement Services
Our physicians perform sharp/surgical debridement using sterile instruments to remove necrotic tissue, callus, hyperkeratotic edges, and biofilm that impede healing. Debridement converts chronic stalled wounds to acute healing wounds, reduces bacterial burden, and allows accurate wound bed assessment. We offer selective debridement targeting only non-viable tissue, non-selective debridement for heavily necrotic wounds, and serial debridement performed weekly or biweekly as needed. All debridement is performed under sterile conditions with appropriate anesthesia and hemostasis.
Advanced Wound Dressings and Biologics
We select dressings based on wound characteristics: foam dressings for moderate to heavily exudating wounds; hydrocolloids for shallow, lightly exudating wounds; alginates for heavily draining wounds with packing capability; hydrogels for dry wounds requiring moisture donation; antimicrobial dressings containing silver, iodine, or medical-grade honey for infected or critically colonized wounds; and contact layers to protect fragile granulation tissue. Cellular tissue products (skin substitutes) include amniotic membrane allografts, umbilical cord tissue, and bioengineered skin containing fibroblasts or keratinocytes that provide growth factors and extracellular matrix scaffolding for wounds failing to progress.
Negative Pressure Wound Therapy
Our NPWT (wound VAC) systems apply controlled subatmospheric pressure (-75 to -125 mmHg) to wounds via sealed dressings connected to portable vacuum pumps. NPWT removes excess exudate and infectious material, reduces edema, increases local blood flow, promotes granulation tissue formation, and draws wound edges together. We use NPWT for Stage 3-4 pressure injuries, Wagner Grade 3-4 diabetic ulcers, dehisced surgical wounds, traumatic wounds, and venous ulcers. Treatment continues until wounds are ready for closure, skin grafting, or advanced biologic application.
Compression Therapy for Venous Ulcers
Venous leg ulcers require compression therapy to counteract venous hypertension and improve venous return. We provide multi-layer compression wraps, Unna boots, adjustable compression wraps, and graduated compression stockings (30-40 mmHg or 40-50 mmHg). Before compression, we assess arterial sufficiency via ankle-brachial index (ABI) to ensure adequate arterial flow. Compression is contraindicated in severe arterial insufficiency (ABI < 0.5) but essential for venous ulcer healing, reducing edema, improving microcirculation, and preventing recurrence.
Insurance Coverage and Payment
Medicare Part B covers medically necessary wound care services including physician visits, debridement (CPT 11042-11047), HBOT for approved indications, NPWT (CPT 97605-97606), cellular tissue products (CPT 15271-15278), therapeutic shoes for diabetics, and compression garments when medically necessary. Most major insurance plans including Blue Cross Blue Shield of Texas, Aetna, United Healthcare, Cigna, Humana, TriCare, and CHAMPVA provide coverage for wound care when documentation supports medical necessity. Our care coordinators verify insurance benefits, obtain prior authorizations for advanced therapies and biologics, and provide cost estimates before treatment begins. Self-pay options and payment plans are available for uninsured patients.
Physician-Led Multidisciplinary Approach
Our board-certified wound care physicians oversee every aspect of treatment, from initial evaluation through wound closure. We coordinate care with podiatrists for offloading and nail care; vascular surgeons for revascularization when arterial insufficiency is present; endocrinologists for glycemic control in diabetic patients; infectious disease specialists for complex osteomyelitis; plastic surgeons for flap coverage or skin grafting; and physical therapists for mobility and offloading education. This multidisciplinary approach addresses all barriers to healing simultaneously, maximizing the likelihood of complete wound closure and preventing recurrence.
How to Access Our Services
Patients can self-refer or be referred by primary care physicians, podiatrists, vascular surgeons, endocrinologists, or other specialists. Call (210) 610-8154 to schedule a comprehensive wound evaluation at any of our three locations. Most patients are seen within 48 hours. Same-day appointments may be available for urgent cases with signs of infection, gangrene, or limb-threatening ischemia. Online appointment requests are available through our website. We accept Medicare and most major insurance plans. Our clinics are located in Bulverde (serving Spring Branch, Boerne, and northern Comal County), Live Oak (serving Northeast San Antonio, Converse, Universal City, Schertz, and Selma), and Southwest San Antonio (serving Lackland AFB, Helotes, Leon Valley, Palo Alto, and south side communities).