Wound care 2010 – a clinician’s perspective!

Abstract

When deciding on a subject matter for my editorial, my creative thoughts turned to what might the wound healing world look like by the end of this current decade – a point in time not that far away. The past decade has seen the evolution of wound care from ‘art’ to science. It is now in most environments regarded as a specialty, but we still has some way to go before we routinely find ‘woundologists’ in every clinical environment with the routine referral of patients to such individuals from clinical colleagues. So what will the next few years bring to the wound care arena from a clinical perspective? There are a number of areas where we could see significant progress: clinical service provision; better, more accessible Continuing Medical Education (CME) offerings; better clinical reach through both management software and telemedicine. These are a few of the active arenas centred on the deliver of medical treatment in the management of wounds. The biggest challenge remaining is ‘engagement’. How do we stimulate others to be interested in wounds and the management of those patients presenting with chronic wounds? Education – Education – Education has to be the primary route to stimulate interest. The evolution of CME and the Internet has been the biggest influence on ‘engagement’. This has occurred through a push–pull relationship where peers push concepts through CME and patients pull concepts from the Internet – often presenting them back to their clinician. This will continue and proliferate over the coming few years with the continued development of wound care ‘information’ on the Internet and newer more easily accessible (through the Internet) CME offerings. The main area of change will be the advent of professional wound care services where patients can guarantee they will see clinicians with an interest and expertise in this area. There is also an increasing awareness amongst policy-makers, health-care planners, clinicians and patients that wounds cost all health-care systems large sums of money and the current provision is so variable, in both quality and quantity and that many patients are denied access to good care. The major challenge will be the design and validation of the many economic models required to demonstrate cost-effectiveness. However, with more appropriate assessment and diagnosis this task will be more easily undertaken. Ultimately with a more structured, tailored approach savings are inevitable. This access to care will be the next main element of the maturing of ‘wound healing’ as a clinical specialty. Access to both care and information will be a major theme for the next few years. This will proliferate rapidly with the adoption of telemedicine technologies. These will remove the communication barriers and in particular reduce the time and cost to access specialised consultation. These major events will shape wound care in the coming few years. By the end of the decade our evolution into true clinical specialists will have taken a significant step forward – probably the largest in our history.