The software was adapted to the routine working practice of the wound care centers. Patient data are entered individually and saved on the local server of each center. To initialize a new patient record, the personal patient data and the name and address of the referring physician have to be entered. Documentation is performed for each wound: the cause of the wound defined according to the German Wound Net guidelines (neuropathic diabetic ulceration, venous ulceration, peripheral arterial disease, pressure sore, etc), wound characterization, wound duration, risk assessment for amputation, and past treatment. Diagnostic and therapeutic procedures are documented in a separate window. Wound localization is documented in a wound localization diagram. Patient compliance is classified as good, acceptable, or poor at each visit, depending on the quality of dressing changes, the adequate use of supporting measures (such as compression therapy or off-loading devices), and reliability in keeping scheduled appointments at the wound care facility (Figure 2). Wound characteristics (amount and type of exudate, callus formation, undermining, maceration, etc) is assessed for each wound. The wound bed is characterized by documentation of the presence of granulation tissue and epithelium, nonviable or deficient tissue, infection or inflammation, moisture imbalance, and a nonadvancing or undermined epidermal margin.15 The presence of edema (yes or no) is evaluated clinically. The wound area is calculated from tracings obtained directly from the wound on Opsite foil (Smith and Nephew Germany, Hamburg, Germany), which are then scanned using a digitizer pad. Wound depth is measured using a probe, and the deepest tissue involved is documented (corium or subcutaneous tissue as grade 1, fascia or muscle as grade 2, and tendon or bone as grade 3) following a modified classification by Knighton et al.16 Wound infection is classified according to the following categories: no infection, superficial infection, deep tissue infection, and systemic infection. Current local therapy, results of microbial tests, supportive measures, and a pain score are documented (Figure 3). A digitized photograph of the wound is taken and transferred to the personal computer using the Smart Media Card. After documentation of these data, the treating physician adds specific comments and a treatment plan to the documented visit. Printouts of the visit are then generated for the patient's record and for the referring physician or the primary care institution.