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Holistic assessment: the patient and wound

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Wound care is a major health concern that significantly impacts many aspects of patients' lives, their health and wellbeing.1,2 It poses a huge burden on NHS resources, with wound dressings alone accounting for at least £120m of primary care prescribing costs in England.3 For the period 2005 to 2006, caring for patients with chronic wounds in the UK cost in excess of £2.3 to 3.1bn per year.4 This does not include the cost of treating acute wounds such as burns and surgical wounds which are at risk of becoming complicated lesions of the skin and underlying tissues if they are poorly managed.5 The human costs such as pain, social isolation and depression are hidden.6

Many of these wounds are dealt with by nurses in the community and GP practices.

The major clinical goals for all chronic and acute wounds are to promote healing by optimising the patient's wound healing potential, and to provide effective local wound care by reducing the risk of infection and complications.7 Healing should be achieved in the shortest timeframe possible,1 although not all wounds will heal (such as those related to malignant disease) and so full healing might not be a realistic outcome for every patient.8

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