Practitioners' knowledge base for assessing and treating chronic ulcers: a scoping review

Chronic ulcers are wounds that have failed to close within 30 days. Practitioners need a solid knowledge base for assessing and treating these ulcers. This scoping review aims to establish the current knowledge base, determine if any medical specialty is more affected by this issue, and if any barriers exist to prevent practitioners from developing that knowledge base.

This scoping review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews and the JBI Manual for Evidence Synthesis. All peer-reviewed literature published in English from 2016-2022 was reviewed. Search terms included: wound care; chronic wound care; algorithms; wound healing; and wound management, with several Boolean operators to maximise the literature results. OneStill Search, through A.T. Still University, US, was used to search for literature, as it covers 198 databases, including PubMed/MEDLINE Plus, CINAHL Plus, and Cochrane Library. Additional literature was obtained through reviewing the reference list of selected studies.

A total of 13 studies matched the criteria of this scoping review. The majority were qualitative and published in 2019, 2020 and 2021. General/primary care practitioners were the main population studied. Despite the current available education, practitioners' knowledge base in assessing and treating chronic ulcers was lacking, with arterial assessment, the use of compression prior to arterial assessment, and the overuse of antibiotics where not clinically indicated, being the three most noted issues. Readily accessible, evidenced-based information in an easy to understand form appeared to be the greatest barrier to improving practitioners' knowledge base.

General/primary care practitioners were shown in this review to have a lack of knowledge base in chronic wounds; however, due to the limited studies in other medical specialties, it could not be determined whether other practitioner groups had a poorer level of knowledge in this field. The review did show the extent of the problem among general/primary care practitioners. Further studies need to be developed with other specialties, especially mid-level practitioners, to solidify the extent of the problem with regards to lack of wound care knowledge. New educational approaches will be needed to address the problems with the current educational tools described in this review.