Wound care: meeting current and future challenges

I am sure that many of you, like me, would have watched the televised coverage of the death of HRH Queen Elizabeth II. What stood out for me in the commentary about her life, was the love she had for her family and the steadfast way she served her country. What was particularly impressive was the way she met challenges, both in public and in her private life by seeking solutions, instead of seeing them as insurmountable problems. This ultimately made me contemplate about how we approach challenges in our professional lives.

In my professional life, I have reviewed a great deal of research into wound care, specifically, where it relates to the management of chronic wounds in the community. The statistics on the burden of non-healing wounds to the NHS and to the individual patient and their carers makes for very grim reading. Fortunately in the UK, we have up-to-date information on the impact of this burden (Guest et al, 2020). Using a sample of 3000 patients' notes in the community between 2017 and 2018, resource use and wound-related clinical outcomes were used to model healing rates and total healthcare resource use (Guest et al, 2020). This analysis estimated the annual NHS cost of wound management to be £8.3 billion, with £5.6 billion (67%) associated with managing non-healing wounds (Guest et al, 2020). 81% of the total annual NHS cost was incurred in the community (Guest et al, 2020). What is even worse is that, when comparing previously collected data from 2012 with that from 2018, it showed a 71% increase in the annual prevalence of wounds from 2.2 million to 3.8 million, along with a parallel increase in resource use (Guest et al, 2017; 2020). In 2017/18 the annual level of resource use attributable to wound management included 54.4 million district or community nurse visits, a nearly 400% increase since 2012 (Guest et al, 2017; 2020). Of course, this problem is unlikely to improve, as the number of elderly people in the population continues to grow. For example, those aged 75 to 84 years in England are projected to increase by 33.9%, and those aged 85 years and over, by 22.8% (Office for National Statistics (ONS), 2018).