Since the start of August, Mr Lee Kim Loon, a 74-year-old retiree, has been making his way to the fourth level of the Medical Centre at Changi General Hospital (CGH). He does so diligently three times a week to get the dressing on his foot changed after losing two toes to gangrene a month earlier.
Lee is among five per cent of Singapore’s population—or one in 20 Singaporeans—who live with wounds that take a long time to heal. With a rapidly ageing population and an increasing rate of diabetes, the number of people who are likely to suffer from wounds that won’t heal within four to six weeks, is expected to rise in the coming years.
But with the opening of the Wound Healing Centre, patients like Lee can now look forward to a faster recovery. The Centre, which was officially opened in December 2021 by Senior Minister of State for Health and Manpower Dr Koh Poh Koon, is the first dedicated wound specialist centre in a public hospital that provides early intervention and outpatient treatment for chronic wounds.
Speaking at the launch of the Wound Healing Centre, CGH’s Chief Executive Professor Ng Wai Hoe said that detecting wounds early and getting them diagnosed and treated quickly are vital.
“We redefined care by designing a seamless one-stop care journey to provide easy, fast-tracked access and convenience to wound care sooner. We encourage everyone with wounds, which do not seem to heal, to seek medical attention early so that we can help them have the best outcomes possible.”
Professor Ng Wai Hoe
Such wounds include diabetic foot, venous and arterial ulcers and pressure injuries, which are often complications of underlying medical conditions.
Patients may also have smaller, hidden wounds that might not be detected until they become infected.
Director of the Wound Healing Centre, Dr Derek Ho, who is also a vascular consultant at CGH's department of surgery, said that these patients’ treatment may be delayed as they get referred to different specialists depending on the location of their wounds.
When wound healing is delayed, complications such as infections and gangrene may arise. Gangrene—a serious complication that commonly affects arms and legs and can lead to amputation—occurs when body tissue dies from a lack of blood flow or a serious bacterial infection.
About 200 amputations are done at CGH each year, most of them caused by diabetes or peripheral vascular disease—a slow and progressive blood circulation disorder.
At the Centre, patients have access to wound specialists with backgrounds in orthopaedic, vascular, plastic, reconstructive and aesthetic surgery as well as wound care nurses.
Ms Png Gek Kheng, Co-Director of the Wound Healing Centre and Chief Nurse at CGH, said, “Chronic wounds often cause immense pain and emotional distress. However, patients and caregivers come to us only during the late stages of the wounds which become harder to treat and can take months or even years to heal. A holistic and coordinated care approach will shorten the runway for the healing process.”
Coupled with a fast-track referral from a polyclinic or emergency department, patients can now be seen at the centre within two weeks. Once there, they are tested, assessed and treated all on the same day in one clinic.
Although the centre was only officially opened in December, its team started treating patients in May 2021 and has been providing an average of 1,000 wound-related consultations and procedures each month.
And Lee is among those who have benefitted. With a history of diabetes, high cholesterol and high blood pressure, his case is also reviewed by vascular and plastic surgeons during his visits.
When reflecting to the media about his progress, Lee said, “My wounds are slowly healing, and I have lost more than 10kg. I’ve also quit smoking for four months. I hope I can heal faster so I can go out to eat.”