Systemic determinants of chronic wound management and pathophysiological responses to current treatment practices

Chronic skin wounds (CW) such as pressure ulcers, diabetic foot ulcers, and venous/arterial leg ulcers are prevalent in older people and people with co-morbid medical conditions such as diabetes. The inability to heal and resolve CW places substantial burden on individuals and healthcare systems, and in many cases can be a catalyst for early entry into residential aged care. Thus, the prevention, identification, and management of CW is an important public health issue. The proposed project will seek to determine systemic management and pathophysiological determinants of CW. Firstly, a health and aged care systems implementation science approach will evaluate contextual barriers and enablers of best-practice wound management. Secondly, the pathophysiology of CW in different stages of wound development and resolution will be dissected using techniques such as vascularisation mapping and immune phenotyping. The project therefore provides a unique opportunity to gain skills in a broad range of research methods including health-service contextual evaluation, qualitative interviews, and biomedical-science techniques to evaluate the effectiveness of therapeutic interventions.