title: Demonstrating a Conceptual Framework to Provide Efficient Wound Management Service for a Wound Care Center in a Tertiary Hospital.
abstract: Although the benefits of wound care services and multidisciplinary team care have been well elaborated on in the literature, there is a gap in the actual practice of wound care and the establishment of an efficient referral system. The conceptual framework for establishing efficient wound management services requires elucidation.A wound care center was established in a tertiary hospital in 2010, staffed by an integrated multidisciplinary team including plastic surgeons, a full-time coordinator, a physical therapist, occupational therapists, and other physician specialists. Referral patients were efficiently managed following a conceptual framework for wound care. This efficient wound management service consists of 3 steps: patient entry and onsite immediate wound debridement, wound re-evaluation, and individual wound bed preparation plan. Wound conditions were documented annually over 4 consecutive years.From January 2011 to December 2014, 1103 patients were recruited from outpatient clinics or inpatient consultations for the 3-step wound management service. Of these, 62% of patients achieved healing or improvement in wounds, 13% of patients experienced no change, and 25% of patients failed to follow-up. The outcome of wound treatment varied by wound type. Sixty-nine percent of diabetic foot ulcer patients were significantly healed or improved. In contrast, pressure ulcers were the most poorly healed wound type, with only 55% of patients achieving significantly healed or improved wounds.The 3-step wound management service in the wound care center efficiently provided onsite screening, timely debridement, and multidisciplinary team care. Patients could schedule appointments instead of waiting indefinitely for care. Further wound condition follow-up, education, and prevention were also continually provided.
authors.affiliation: From the Department of Dermatology, Shuang Ho Hospital, Taipei Medical University, Taipei, Taiwan (Y-TC); School of Public Health, College of Public Health and Nutrition, Taipei Medical University, Taipei, Taiwan (Y-TC); Division of Plastic Surgery, Chang Gung Memorial Hospital, Chiayi, Taiwan (C-CC, J-HS, W-NL); Department of Plastic surgery, School of Medicine, College of Medicine, Chang Gung University, Taoyuan City, Taiwan (C-CC); and Graduate Institute of Nursing, Chang Gung University of Science and Technology, Taoyuan City, Taiwan (M-YC).
authors.forename: Yu-Tsung
authors.initials: YT
authors.lastname: Chen
authors.forename: Chang-Cheng
authors.initials: CC
authors.lastname: Chang
authors.forename: Jen-Hsiang
authors.initials: JH
authors.lastname: Shen
authors.forename: Wei-Nung
authors.initials: WN
authors.lastname: Lin
authors.forename: Mei-Yen
authors.initials: MY
authors.lastname: Chen
mesh_terms: D000368:Aged; D003646:Debridement / Q000592:standards*; D017719:Diabetic Foot / Q000601:surgery*; D019468:Disease Management; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D062606:Tertiary Care Centers; D014945:Wound Healing