Assessment of wounds in adults

Patients can require wound care at all ages, from infants to the elderly, and nursing practice can vary from primary or secondary care and long-term care institutions. Recent studies have recommended that wound care should be viewed as a specialism, which requires clinicians to have specialist training to diagnose and manage wounds appropriately (Guest et al, 2015). However, evidence suggests that this is not current practice. It has been recommended that effective treatment, diagnosis and prevention of wound complications could help reduce treatment costs and reduce the economic burden of wounds on the NHS (Guest et al, 2015). The estimated annual NHS cost in England for managing wounds after adjustment for comorbidities is £4.5-5.1 billion with two-thirds of this cost incurred in the community (Guest et al, 2015). The findings from this study indicated that approximately 30% of wounds lack a differential diagnosis. This could be indicative of a lack of experience by non-specialist health professionals in the community. The findings of Guest et al (2015) highlighted the need to change approaches to wound assessment and improve the quality of patient care. This has been actioned by the inclusion of wound assessment as a key indicator in the Commissioning for Quality and Innovation (CQUIN) framework for 2017-19 (Scott-Thomas et al, 2017). It is therefore essential for health professionals to improve their knowledge and skills in wound assessment.