Best practice, best products, best outcomes in community wound care: three descriptive cohorts

Abstract

Aim To determine the number of clients with wounds, and the types of wounds, admitted to an Australian community nursing service, and to describe their healing trajectory and cost of treatment labour and consumables. Method Point-of-care data from three retrospective cohorts of clients admitted for community wound care between 1 November 2016 and 30 June 2021 was analysed descriptively. Results The three cohorts comprised 41,865 clients; the median age was 74 years (interquartile range [IQR] 58–84), with 88,793 wounds. Healing is complex, and heterogeneity in healing times and costs was demonstrated as anticipated a priori. Acute wounds were the most common across all three cohorts (38–45%, 40% overall), followed by skin tears (15–17%, 16% overall), leg ulcers (13–14%, 14% overall) and foot ulcers (7–9%, 9% overall). The median length of treatment for all discharged wounds was 18–22 days. Acute wounds and skin tears had the shortest length of treatment, and benign and malignant tumours the longest. For each cohort, eight out of 10 wounds were discharged healed or were transferred to self-care. Stage 4 pressure injuries, open incisions following amputation, fistulae and venous leg ulcers (VLUs) were the most costly to manage. Conclusion This study provides an important account of consumable and direct labour costs to treat Australian community wounds. Healing/self-care outcomes were consistently favourable.