A specialized wound-healing center concept: importance of a multidisciplinary department structure and surgical treatment facilities in the treatment of chronic wounds.

The optimal way to improve prophylaxis and treatment of patients with problem wounds is to create an independent multidisciplinary wound-healing center that focuses on all types of problem wounds and has an outpatient clinic, as well as an inpatient ward. An integrated wound-healing department concept should be a standard in wound healing. A department structure containing both an outpatient clinic and inpatient ward, employing full-time personnel, allows the development of all features vital for optimal wound treatment. These are standardized treatment plans, access to relevant objective investigative methods and surgical approaches, a higher degree of continuity in treatment, increased patient satisfaction, greater potential for education and training, and improved possibilities for basic and clinical research in healing and care. The Copenhagen Wound Healing Center, Copenhagen, Denmark, and the University Center of Wound Healing, Odense, Denmark, are examples of this type of department. Initial results have demonstrated that these concept centers have resulted in improved rates of healing in patients with leg ulcers and have decreased the necessity for major amputations. The structure of the centers also offers greater opportunities for both basic and clinical research and provides expert education for all types of health care personnel. The centers were created in an attempt to establish an expert function in wound healing that would be fully integrated into the Danish national health care system. This model may, with individual modifications, be applicable for both industrialized and developing countries. In case it is impossible to realize the model in its entirety, alternative center concepts should be considered.