OBJECTIVE: The purpose of this study was to understand the decision-making process used when selecting ulcer-dressing products, and to ascertain the use of health economics in the decision process. METHODS: Diverse groups of nurses highly involved in product selection were interviewed. The groups included five home care nurses (Group 1), four acute care nurses (Group 2), and five nurses who spent some time in LTC (Group 3). Discussions centered on 1) Product Switching Triggering Events, 2) Key Decision-Makers, 3) Mapping the Decision-Making Process, and 4) Understanding of Health Economics. Information about the key decision-makers at different institutions was discussed. RESULTS: 1) Performance issues were the most common reasons for product switching (66%). Product availability was the most influential factor (48%). 2) No differences in product selection criteria were observed among nurses in home, acute and long-term care. However, level and role of the nurse in each setting influenced his or her part in decision-making and product selection. 3) Product evaluation and hands-on experience were the most important elements for selecting a new or replacement product. The ability to incorporate the product into customized patient protocols was also important. 4) While nurses were somewhat familiar with the term "cost-effectiveness," most preferred the term "value." Approximately half used such information to support wound-care product decisions. Nurses were more likely to consider a product supported by a straightforward economic assessment rather than a complex decision analysis. CONCLUSION: Product selection relies heavily on trial evaluations. In addition, published health economic studies are often too complicated. In order for health economics research to inform decision-making in the wound care market, studies should: 1) identify target audiences and address their decision-making needs; 2) "speak" to their audience by using terms familiar to decision-makers; and 3) present simplified diagrams, charts or models.