OBJECTIVE: To demonstrate that changes in demography, life expectancy and incidence of background diseases (including type 2 diabetes mellitus) during the period 2009-2020 will significantly increase the costs of wound care in Denmark. METHOD: A simple activity-based equation, which was applied to Danish national statistics on medical conditions and key financial figures from previously published surveys. RESULTS: Currently, DKK 735m (99m Euro) is spent each year on municipal wound care. Denmark's population is 5.4 million and about 18,000 wounds can be expected annually in the municipal sector, requiring more than three million dressing changes. These figures are expected to rise significantly up until 2020. The percentage of senior citizens will rise by 22% during this time and the number of patients with type 2 diabetes mellitus will increase by 22-24,000 per year. Improved treatments and longer life expectancies will increase the elderly population by 40,000. These changes will cause a gradual rise in wound care costs of up to 30%, corresponding to DKK 224m (30m Euro) in 2020. However, by adopting a national strategy based on best practice guidelines, it may be possible to intercept this increase in costs. A national strategy in Denmark seems to have the potential to reduce costs by a matching 30%. If Denmark fails to adopt a national strategy, an accumulated loss of DKK 1.5 billion (206m Euro) can be expected over the next decade. CONCLUSION: Wound therapy will pose a major economic challenge to Denmark in future if no intervention is carried out. This study presents an empirical model calculating the economic consequences of future challenges such as demography, lifestyle and type 2 diabetes mellitus. It is suggested that a national strategy for wound therapy may convert a future deficit to zero-balance. Similar challenges are expected in other western European countries.