Sam Gregory-Jones was the only registered nurse working in her small country hospital when her young son was brought in for urgent treatment.
"Our two-and-half-year-old son Thomas had put his hands on the fireplace," she said.
When he arrived at the hospital, Ms Gregory-Jones had to stay in professional work mode.
"That was quite traumatic because, of course, he wanted his mum but I had to be nurse," she said.
"I triaged him and treated him, giving him medication."
Ms Gregory-Jones consulted doctors at a major Sydney hospital, a four-hour drive away, who recommended she use a specific antimicrobial dressing on Thomas's burns, but the small country hospital did not have that dressing in stock.
"We had to put him in a cast all the way from his hands to his elbow, so he couldn't use his hands," she said.
"And we just used the dressings that we did have on hand."
On that ill-fated evening, Thomas became one of an estimated 420,000 Australians who suffer from chronic wounds on any given day.
And like tens of thousands of them, Thomas needed dressings, treatments, and specialist care that the local country hospital was not equipped to provide.
So over the next few months, Ms Gregory-Jones and Thomas made the eight-hour round trip to Sydney from their home in western New South Wales five times to have his wounds treated.
Fortunately, they did not have to pay accommodation costs in the city — which can be prohibitive for country patients requiring treatment at metropolitan hospitals.
"We were lucky because we have family in Sydney … just paying for the petrol five times was a big expense," she said.
"We all decide to live out here because it's beautiful but our postcode should not determine what kind of services we get.
"We're living in the 21st century."
Now 18 months after the accident, Thomas is still receiving treatment for his hands to encourage movement and strength and minimise the effects of scar tissue.
"It's going to be an ongoing thing for quite some time," his mum said.
Chronic wounds a 'huge, silent epidemic'
Wounds Australia chair Hayley Ryan said many people in rural areas did not have the benefit of a loved one with medical knowledge to treat their wounds or the means to make frequent trips to the nearest city for appropriate care.
"It's a huge, silent epidemic," she said.
"Around 420,000 Australians suffer from a wound at any one time.
"It costs around $3 billion to treat, which is about 2 per cent of [yearly] health expenditure."
Ms Ryan, who is a nurse and trained in wound care, said many people did not expect their minor injuries to develop into chronic wounds.
"I've got a patient at the moment, he's gone for a surf, he's stubbed his toe in the sand and it's turned into a horrifying wound," she said.
"He didn't seek treatment in a timely manner. In fact, he waited a good three months to then go and seek treatment.
"Now we're looking at potentially amputation if we don't start acting on it."
Ms Ryan said anyone with a wound that was not healing after four weeks should seek medical treatment.
She said any wound that smelt bad or had fluid coming out of it should also be checked by a medical professional.
Invest in treating wounds early, say doctors
A new report by the Australian Medical Association reveals that people living in rural and remote Australia, lower socio-economic populations, and Aboriginal and Torres Strait Islander people are all "disproportionately affected" by chronic wound issues.
It quotes a study that showed 41 per cent of outpatients in the Midwest region of Western Australia were seeking treatment for chronic wounds.
AMA vice president Danielle McMullen said the analysis in the report showed a $23.4 million investment in preventing and treating chronic wounds would yield a $203 million benefit over four years.
"This is a no-brainer for a government desperate to cut the deficit," Dr McMullen said.
"I don't know of many investments where for every $1 you spend, the return is $8.36, but this is the case with evidence-based wound care," she said.
Dr McMullen said one huge cost was for special dressings for open wounds, like those that could have helped Thomas when he first arrived at the country hospital.
She said while they were free for patients in hospitals, someone had to pay for them if they were used in a GP clinic.
"At the moment, Medicare doesn't cover the cost of the dressings we need to treat chronic wounds correctly," she said.
"So doctors are either bearing the costs themselves or are forced to pass on the cost to patients, and that’s not something we like doing."
She said that created an incentive for patients to go through the hospital system, not their local GP, which the AMA claims is more expensive than treating someone in a GP clinic.
The AMA report quotes a 2013 study that found patients over 60 with venous leg ulcers were spending $27.5 million on dressings alone.
The association is also calling for a new Medicare rebate that applies to practice nurses, Aboriginal and Torres Strait Islander health practitioners and Aboriginal health workers treating and cleaning wounds.
Under the existing rebate scheme, a GP needs to be in the room in order for a rebate to be claimed — even if the nurse or health worker does all the work.
In a statement, the Department of Health and Aged Care said it was studying "wound consumables" such as dressings, with results to be sent to the federal government in June next year.
The department said this directly addressed one of the recommendations from the AMA and Wounds Australia.
It also said that implementing recommendations from the Royal Commission into Aged Care Quality and Safety would improve wound care for older Australians.
