OBJECTIVES: Chronic wounds are wounds that last for over 4 weeks; or those borne of an underlying aetiology such as venous insufficiency or diabetes, regardless of duration. These wounds can last a long time and affect a patient’s quality of life (QoL) over a period of months and years. This review examined the patient perspective and QoL burden of living with and treating a chronic wound using topical interventions.

METHODS: A systematic review based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines was carried out. Databases searched included: Science Direct, NICE Evidence search, Medline (PubMed), Centre of Reviews and Dissemination (University of York), and the Cochrane Database, additional literature identified through discussion with experts and manufacturers. Data extraction was performed by a team of three researchers and conducted in 2 parts. 1) Qualitative studies examining patient perspectives were addressed using thematic analysis and, 2) Clinical trials that included a QoL endpoint measured with a standard tool were addressed using a narrative synthesis. A critical appraisal was performed using the Hawker tool for assessing qualitative studies.

RESULTS: 3422 records identified. After initial screening of titles and abstracts, 817 full text articles were judged versus inclusion and exclusion criteria and 19 studies included (11 qualitative studies and 8 RCTs). Of the 11 qualitative studies, 5 assessed Venous Leg Ulcer (VLUs) 2 examined Pressure Ulcers (PUs), 1 Diabetic Foot Ulcers, and 3 investigated chronic wounds more broadly. Of the 8 RCTs included for data extraction, 6 assessed VLUs and 2 DFUs.

CONCLUSIONS: Patients with chronic wounds incur a substantial QoL burden, presenting with pain, diminished mobility and a sense of ‘loss of self’. In addition to using standard measures, other qualitative methods identify important dimensions such as odour, exudate, pain, anxiety/depression and social isolation.