Abstract
Between 2014 and 2019, the prevalence of chronic wounds among Medicare beneficiaries rose from 14.5% to 16.4%, with a particularly sharp increase among younger individuals with disabilities. Despite this rise, total treatment costs declined from $29.7 billion to $22.5 billion, suggesting a shift toward more decentralized care models. Notably, spending increased for venous ulcer treatment and durable medical equipment, indicating greater use of advanced dressings and home-based technologies. These changes reflect an evolving wound care landscape marked by growing reliance on outpatient and home care services. However, they also underscore persistent disparities in access to quality care, especially for vulnerable populations. At the same time, wound care research continues to be limited by the fragmentation and inaccessibility of scientific knowledge. The dominance of randomized controlled trials (RCTs) within the traditional evidence hierarchy fails to fully account for the complexity and heterogeneity of wound care contexts. To address these limitations, a circular model of research is proposed—one that integrates RCTs, observational studies, and clinical experiences. This inclusive approach recognizes the value of diverse sources of evidence and promotes the development of scalable and context-sensitive solutions. Ultimately, advancing wound care requires not only technological innovation but also open, collaborative, and patient-centered research capable of informing practice across all settings.
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