Workload and prevalence of open wounds in the community: French Vulnus initiative

To calculate the prevalence of open cutaneous wounds presented on a routine working day in community settings in metropolitan France, and to estimate the workload associated with the care of these wounds by nurses, GPs and specialists (dermatologists, diabetologists and phlebologists).

A transversal epidemiological survey was conducted on a randomly selected sample of the above practitioners between June and July 2008. The percentage of patients presenting on a routine working day with open a cutaneous lesion of any origin, location, size and duration was assessed. All local and systemic care performed on the patient during that day because of the wound was also recorded.

In total, 475 GPs, 453 specialists and 238 nurses participated (n=1166) and saw a total of 29 663 patients, of whom 3037 presented with one or more cutaneous wound. The overall non-weighted prevalence of patients with a wound was 10.2% (95%CI: 9.9%;10.6%). This prevalence was similar for GPs (6.0%) and for specialists (6.9%), but was higher for nurses (22.0%). Forty-three per cent of all wounds had a duration of over 6 weeks. These chronic wounds were predominantly leg ulcers, diabetic foot ulcers or pressure ulcers, but also included wounds of all aetiologies. For 33% of all patients with wounds, the impact on their health status was serious to severe. The overwhelming majority of wounds (95%) required local care, including in 65% of cases cleansing and debridement.

Despite its limitations, this initiative, the first of its type in France, strongly suggests that wound care constitutes an important part of routine care given by health professionals in the community, and for a substantial number of these patients, wounds represent a serious morbidity.

The non-profit organisation 'Association Vivre avec une Plaie' financially supported this study. This association received unrestricted grants from the French Wound Healing Society (SFFPC) and a consortium of private companies (main sponsors: ConvaTec, Genevrier, Hartmann, KCI, Mölnycke, Smith & Nephew, Urgo; minor sponsors: Coloplast, Covidien, HNE) to fund the costs incurred by the methodological process and statistical analysis but had no input into the findings. The National Health Insurance Organisation provided non-financial support to this initiative. J.C. Kerihuel received support for the submitted work from 'Association Vivre avec une Plaie'. S. Meaume, I. Fromantin and L. Téot have no financial relationship with 'Association Vivre avec une Plaie', for either this or any work submitted in the previous 3 years. The authors have no non-financial interests that may be relevant to the submitted work, and their spouses, partners, or children have no financial relationships that may be relevant to the submitted work