As the cost of wound care mounts, are we now in a position where we should consider whether every clinician needs access to every dressing? The author suggests that a very large percentage of the wounds seen on a daily basis could be managed with a small number of dressings, while those requiring more advanced care should see a specialist practitioner. This would provide a structure for a good early referral system pathways where wound care specialists could make better informed decisions about what more difficult wounds need. This is not about rationing, but rather is about evidence-based practice and improving patient care.