Creation of a National Chronic Wound Registry-Challenges and Opportunities

Chronic wounds pose an increasing burden on the healthcare system and data on wound outcomes and are needed to evaluate and address disparities and reform healthcare policies. In Singapore, data on chronic wounds are fragmented and to address this, we established a Chronic Wounds Registry (CWR) to collect harmonised data on chronic wounds and their outcomes over 6 months. This is a multi-centre prospective cohort study from Nov 2019 to Nov 2021. Patients with chronic wounds were enrolled at multi-speciality acute care hospitals and data were prospectively collected on baseline characteristics, including subject demographics, clinical data, wound images, interventions/treatment, cost burden and patient reported health-related quality of life (HRQOL). Patients were followed up for 6 months and wound outcomes recorded at Month 1, Month 3 and Month 6 time points. Despite the onset of COVID pandemic, a total of 812 patients were recruited in our study. Mean age was 63.5 ± 11.6 years with 66% men and 59% of Chinese ethnicity. Twenty percent of all the wounds were recurrent and patients with venous leg ulcers (VLU) (32%) had the highest recurrence. At 6 months, 225 (46%) of the neuro-ischemic ulcers (NIU), 152 (60%) of the VLUs and 29 (46%) of the pressure injuries (PI) had healed. Major (5%) amputations were highest in patients with NIUs. All-cause mortality was highest (30%) and HRQOL was lowest for patients with PIs (-0.18). Development of a national wound registry is both feasible and essential to consolidate key data elements on chronic wounds. The CWR in its current state captured the local epidemiology, patient journey in acute care hospitals, which will benefit in healthcare policymaking and harmonise care across different levels of healthcare system. The next phase of the CWR aims to track patients in all settings and collect data on the entire patient journey following an episode of wounding.