Innovation in wound healing.

Abstract

There remain many challenges in the field of wound healing if we are to see patients with this common and expensive clinical problem receiving professional and academically sound care. The recent work focussing on collecting epidemiological and cost-effective data related to current service provision are all indicating the problem of wound healing is much more common and much more expensive than was previously suspected. Innovation in terms of capturing relevant and accurate data is one great challenge we need to address. In our opinion we need colleagues to accept that when discussing this subject with politicians and health service planners, if we do not have data then these people will think there is no problem in clinical care of patients with wounds. Innovation can be seen in many ways. The most obvious way of innovating care in practice is to focus exclusively on new technology that offers new treatment options to patients. It should also be remembered that the therapeutic armamentarium for clinicians treating patients with wounds includes dressings, devices, drugs, surgical procedure and biological approaches to treatment. However technological development alone will not always lead to patients receiving the correct treatment at the right time for the right reason with the right outcome unless more comprehensive means of selecting such treatment are developed by the creation of accurate and affordable assessment and diagnostic tools. Innovation needs all stakeholders working in the arena of wound healing to come together and collaborate. It is no longer acceptable for industry to develop a new treatment and then find a niche where it can be used. Partnerships between industry, clinicians and academics are needed to ensure that new therapies are developed to meet clinical needs. Traditionally, translational research talks about moving from bench to bedside. It is far more likely to be effective if innovations are driven from bedside to bench. Industry needs to accept that the diversity of the clinical problem is such that no single intervention is ever likely to treat all wounds at all stages and a mature and honest approach is needed by clinicians who want to have simple solutions to complex problems. More important than technological innovation is system, service and process innovation as it is not too sweeping a statement to say that at the current time none of us should be confident that all patients in our clinic, hospital, town or country will receive even basic aspects of care on a consistent basis. The need for new models of care to be developed and evaluated is increasingly important as we are all drowning in the avalanche of patients in our place of work with wound healing difficulties. Rather than focussing on new funding for providing wound services we should perhaps look at methods to capture accurate and comprehensive costs of care for an episode of wounding rather than simply focussing on the unit cost of a topical treatment. Coordination of care for patients with wounds will be one of the greatest challenges and opportunities we will face in driving this subject forward. Often forgotten in the arena of innovation is the need for citizens in our society to engage in social innovation. This could include patients becoming more involved in their own care and for family members and friends to act as care givers to patients where and when appropriate. The pressures on health care staff are increasing rapidly and the difficulties for all health care systems to ensure equity of access to all citizens will increase the need for these developments to move forward. This should also be supported by members of any society changing their behaviour to reduce the risk of developing a disease or reduce the chances of complications of that disease developing, e.g. diabetes, obesity or poor nutrition. It is only by us all engaging in these diverse forms of innovation and ensuring that we look at new and different ways of diagnosing, treating and providing care for patients with wounds will be realise the full extent of health gains we can achieve in this important and challenging area of clinical care.