Wound Care Knowledge, Self-Management Practice and Wound Healing Outcomes among Adult Patients with Chronic Wounds in Southwest Nigeria: A Cross-Sectional Study

Chronic wounds represent a substantial and under-recognised burden on health systems in sub-Saharan Africa, consuming disproportionate clinical resources and imposing prolonged physical, psychological and economic costs on affected individuals. Because the greater part of wound care after the initial clinical encounter is necessarily carried out by patients themselves, healing outcomes depend heavily on what patients know about wound care and on how consistently they translate that knowledge into daily self-management. Despite the growing prevalence of diabetes and other chronic conditions predisposing to wounding in Nigeria, empirical evidence linking patients’ wound care knowledge and self-management practice to measurable healing outcomes remains scarce. This study therefore examined wound care knowledge, self-management practice and wound healing outcomes among adult patients with chronic wounds attending selected secondary and tertiary healthcare facilities in Southwest Nigeria.

The study was anchored on Orem’s Self-Care Deficit Nursing Theory, which explains how a deficit between an individual’s self-care demand and their self-care agency generates the need for nursing intervention, with Bandura’s Self-Efficacy Theory and the TIME framework for wound bed preparation providing complementary behavioural and clinical perspectives. A facility-based analytical cross-sectional design was adopted, involving 302 adults with wounds of at least four weeks’ duration. Participants were selected through systematic sampling from wound care, surgical outpatient and diabetes clinics. Data were collected using a validated wound care knowledge and self-management practice questionnaire and a structured wound healing outcome assessment instrument scored on a 0–100 scale. Data were analysed using descriptive statistics, chi-square analysis, Pearson’s correlation, one-way analysis of variance and multiple linear regression, with statistical significance established at p < 0.05.

The findings revealed that 39.1% of respondents had adequate wound care knowledge, while 35.1% and 25.8% demonstrated marginal and inadequate knowledge respectively; corresponding figures for self-management practice were 34.4%, 37.4% and 28.1%. The mean wound healing outcome score was 58.6 ± 15.2, indicating a moderate level of healing progress. Both wound care knowledge and self-management practice exhibited moderate positive and statistically significant relationships with wound healing outcomes (r = 0.47 and r = 0.52 respectively, p < 0.001). The regression analysis further showed that adequate self-management practice, adequate wound care knowledge, absence of comorbid diabetes mellitus, wound duration of less than twelve weeks and tertiary educational attainment significantly predicted better healing outcomes, the model accounting for 41% of the variance in healing scores.

The study concludes that wound care knowledge and, more strongly, self-management practice are significant predictors of wound healing outcomes among adult patients with chronic wounds in Southwest Nigeria, and that the effect of practice is not reducible to knowledge or formal education alone. Strengthening patients’ capacity for wound self-management through structured, culturally appropriate education integrated into routine wound care can shorten healing trajectories and reduce complication rates. The study therefore recommends that structured wound self-management education, supported by teach-back counselling and simplified visual materials, be incorporated into routine wound clinic practice, with priority given to patients with comorbid diabetes and wounds of longer duration.

Keywords: Wound care knowledge; self-management practice; wound healing outcomes; chronic wounds; diabetic foot ulcer; Southwest Nigeria.