Arterial Ulcers, Calciphylaxis, Chronic Ulcer, Diabetic Foot, Diabetic Foot Ulcers (DFUs), Leg Ulcer, Lymphedema, Peripheral Arterial Disease, Pressure Injury, Pressure Ulcer, Pressure Ulcer (PU), Pyoderma, Sickle Cell Ulcer, Skin Ulcer, Soft Tissue Radionecrosis (STRN), Surgical Complication, Surgical Wound Dehiscence, Traumatic Wounds, Vasculitis, Venous Leg Ulcers (VLUs)
Conditions
Keywords
Qualified Clinical Data Registry, Quality Measures, Clinical Data Research Network, Real world data, chronic wounds, chronic ulcers, Diabetic Foot Ulcer, Venous Leg Ulcer, Pressure Ulcer, Pressure Injury, Arterial Ulcer, Traumatic Wound, Surgical Complication, Pyoderma Gangrenosum, Advanced Wound Care, Skin Substitutes, CAMPs, CTPs, Negative Pressure Wound Therapy, NPWT, Collagen Dressings, Compression Therapy, Hyperbaric Oxygen Therapy, Wound Debridement, Real-World Evidence, Comparative Effectiveness, Wound Healing, Amputation, Electronic Health Record (EHR), Debridement, Standard of Care
Brief summary
WOUNDJOURNEY is a longitudinal, real-world, observational registry designed to capture the full clinical course and patient journey associated with chronic wounds and ulcers. Data are collected during routine care from over 1,400 clinicians across the USA and Puerto Rico using a highly structured certified electronic health record (EHR) or electronic data capture (EDC) system. Data are transmitted daily to the U.S. Wound Registry (USWR), a CMS-recognized Qualified Clinical Data Registry (QCDR). The registry captures real-time, research-ready data on patient demographics, comorbidities, wound characteristics, standard-of-care treatments, complications, and advanced therapeutics. It supports robust, fit-for-purpose real-world evidence generation by enabling risk-adjusted outcome analysis, comparative effectiveness research, and quality improvement across diverse sites of care.
Detailed description
WOUNDJOURNEY is a longitudinal, real-world observational registry focused on the chronic disease burden and patient journey of individuals with chronic wounds and ulcers. Data collection began in 2005 and continues prospectively, capturing structured clinical data at the point of care using a purpose-built certified EHR or EDC system. These data are securely transmitted to the U.S. Wound Registry (USWR), a CMS-designated Qualified Clinical Data Registry (QCDR). All major wound types are represented: Diabetic foot ulcers (DFUs), diabetic ulcers not on the foot, Venous leg ulcers (VLUs), Arterial ulcers, Pressure ulcers/injuries, Surgical complications, Traumatic wounds, Vasculitic/inflammatory, and sickle cell-related ulcers, and chronic non-pressure ulcers. The registry collects detailed data on standard-of-care practices and advanced wound care interventions, including brand-specific information on: Advanced dressings (e.g., collagen, antimicrobial), Compression therapy, Offloading devices, Cellular and/or tissue-based products (CTPs) also called Cellular, Acellular, or Matrix-like Products (CAMPs) or skin substitutes, Negative pressure wound therapy, MIST therapy (low-frequency ultrasound), Topical oxygen therapy (TOT), Hyperbaric Oxygen Therapy (HBOT), Topical growth factors (e.g., Becaplermin), Enzymatic and mechanical debridement, Fluorescent imaging for bacterial load, Topical antibiotics and antimicrobials, and other treatments. The registry captures key elements of the patient journey, including: Frequency of debridement, Sites of care, number of patient visits and number of wound visits, Dressing changes, Use and timing of advanced therapies, Comorbid disease burden and clinical complexity, Patient Frailty, number of wounds and ulcers per patient, patient time in service, wound time service, patient and wound outcomes, the development of new wounds while in service and complication rates. Wounds are risk stratified using the Wound Healing Index, enabling case-mix adjustment and longitudinal outcome tracking. Follow-up may extend over five years, capturing outcomes such as: Complete healing (epithelialization), Non-healing, Major and minor amputations, Mortality, and Loss to follow-up or transfer of care. Quality of care is assessed using wound-specific quality measures. The registry integrates real-world clinical care with research and quality improvement, supporting a learning healthcare system model. Through secure tokenization, registry data may be linked to payer claims for comprehensive longitudinal analysis of healthcare utilization, interventions, hospitalizations, medication use, and long-term outcomes across care settings. This enables rigorous, policy-relevant evaluations of standard care and advanced wound therapies in routine practice. The robust patient and wound level data are suitable to understand the natural history of chronic wounds and ulcers and to create historical controls for prospective clinical trials.
Interventions
advanced dressings, off-loading, venous ulcer compression, arterial screening
Sponsors
Study design
Eligibility
Inclusion criteria
* Presence of one or more chronic wounds or ulcers of any etiology * Wound or ulcer must be treated at a participating site (which can be a hospital outpatient department, office, mobile practitioner, in the home setting, skilled nursing, etc.) * Care must be documented using the purpose-built, wound-specific structured electronic health record (EHR) or electronic data capture (EDC) system * All ages, including infants and patients aged 90 years or older (reported in aggregate in accordance with HIPAA de-identification standards) * All sexes and gender identities * All wound types and severities, including multiple wounds per patient
Exclusion criteria
-None (the registry includes all eligible patients treated at participating sites without sampling or
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Healed | 1 year | Wound closure by secondary intention |
| Major amputation | 1 year | Below the knee, above the knee |
| Minor amputation | 1 year | toe amputation, transmetatarsal amputation, midfoot amputation |
| Patient Death | 1 year | patient death while in treatment |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Percent surface area (PAR) reduction over time | variable - measured at multiple intervals (e.g., 4, 12, 16, 24, and 52 weeks) | Percent surface area reduction (PSAR) is defined as the percentage decrease in wound surface area from the initial documented size at baseline (first qualifying wound care visit) to subsequent visits over time. Wound surface area is measured using length × width, captured at the point of care using structured fields within the electronic health record (EHR) or electronic data capture (EDC) system. Values are recorded in cm² and used to calculate PSAR as: \[(Baseline area - Follow-up area) ÷ Baseline area\] × 100 This metric is assessed at multiple time intervals, including 4 weeks, 12 weeks, 16 weeks, 6 months, and 12 months. PSAR is a key performance indicator for healing trajectory and is used to evaluate response to interventions. All wound types are included, and multiple wounds per patient are analyzed independently. Surface area measurements are case-mix adjusted using the Wound Healing Index for comparative effectiveness and quality reporting. |
Countries
United States