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Why the NHS needs to radically rethink chronic wound care

Mark Greener details the burden of managing chronic and acute wounds in primary care

Nurses know the toll that chronic wounds exert from patients. The pain. The emotional and physical distress.1 The smell, which can cause embarrassment, disturbed sleep, anxiety, depression and low self-esteem.2, 3 The exudate that leaks onto furniture, bedding and clothes.2 The social isolation. The reduced mobility, partly because of the all-too-frequent amputations.1 Not surprisingly, chronic wounds often leave patients’ partners and families experiencing ‘severe emotional and physical trauma’.1

Wounds also exert heavy financial and clinical tolls. In 2012/2013, the NHS managed an estimated 2.2 million patients with wounds, equivalent to about 4.5% of adults. Managing these wounds and the associated co-morbidities involved 18.6 million practice nurse visits, 10.9 million community nurse visits, 7.7 million GP visits and 3.4 million hospital outpatient visits, which cost the NHS £5.3 billion. The economic burden imposed by wounds on the NHS is ‘comparable to that of managing obesity’.4 Yet chronic wounds capture a fraction of the attention paid to obesity.

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