Innovative project to improve the accessibility of advanced wound care among chronic wound patients in Yunlin County, Taiwan: "Fight Out to CARE"

Hui-Hsiu Chang; Wen-Chu Chiang; Chen-Shu Chang; Chau-Chen Torng; Matthew Huei-Ming Ma

doi:10.1016/j.jfma.2024.11.021

Innovative project to improve the accessibility of advanced wound care among chronic wound patients in Yunlin County, Taiwan: "Fight Out to CARE"

J Formos Med Assoc. 2024 Dec 9:S0929-6646(24)00558-8. doi: 10.1016/j.jfma.2024.11.021. Online ahead of print.

Authors

Hui-Hsiu Chang¹, Wen-Chu Chiang², Chen-Shu Chang³, Chau-Chen Torng⁴, Matthew Huei-Ming Ma⁵

Affiliations

¹ Wound Healing Center, Department of Surgery, National Taiwan University Hospital Yunlin Branch, Yunlin, Taiwan; Division of Plastic and Reconstructive Surgery, Department of Surgery, National Taiwan University Hospital Yunlin Branch, Yunlin, Taiwan; Department of Industrial Engineering and Management, National Yunlin University of Science & Technology, Yunlin, Taiwan. Electronic address: [email protected].
² Department of Emergency Medicine, National Taiwan University Hospital Yunlin Branch, Yunlin, Taiwan; Department of Emergency Medicine, National Taiwan University Hospital, Taipei, Taiwan.
³ Wound Healing Center, Department of Surgery, National Taiwan University Hospital Yunlin Branch, Yunlin, Taiwan.
⁴ Department of Industrial Engineering and Management, National Yunlin University of Science & Technology, Yunlin, Taiwan. Electronic address: [email protected].
⁵ Department of Emergency Medicine, National Taiwan University Hospital Yunlin Branch, Yunlin, Taiwan; Department of Emergency Medicine, National Taiwan University Hospital, Taipei, Taiwan. Electronic address: [email protected].

PMID: 39658417
DOI: 10.1016/j.jfma.2024.11.021

Abstract

Yunlin County, Taiwan, faces healthcare challenges given its super-aged population, limited medical accessibility, and a rise in chronic wounds. To address these issues, we introduced the "Fight Out to CARE" project, dispatching wound nurses to patients' locations to perform Cleansing, Avoidance, Removal, and Enhancement (CARE) under tele-supervision from a plastic surgeon. The program was conducted weekly in 2018 and twice monthly in 2019 for 53 weeks. We included 189 patients with 349 wounds in 17 homes and 17 long-term care facilities across 11 towns. Pressure injuries (PIs) comprised 67% of all wounds, with 96% of PIs categorized as full-thickness (FTPIs), including Stage 3, Stage 4, and Unstageable. Overall, 174 wounds healed, with 43% of PIs and 41% of FTPIs healed; 37% of PIs healed within 12 weeks. This innovative approach improved accessibility to chronic wound care and demonstrates promising healing outcomes, providing a valuable reference for chronic wound care policy.

Keywords: Debridement; Delivery of health care; Pressure injury; Telemedicine; Wounds and injuries.