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Cacua Sánchez MT, Botero AM, Moreno-Mattar O. Cost-effectiveness analysis of intralesional and perilesional recombinant human epidermal growth factor vs hydrocolloid therapy in venous ulcer treatment in the Colombian context. J Vasc Surg Venous Lymphat Disord 2024; 12:101745. [PMID: 38145819 DOI: 10.1016/j.jvsv.2023.101745] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Revised: 12/09/2023] [Accepted: 12/14/2023] [Indexed: 12/27/2023]
Abstract
OBJECTIVE To perform a comparative analysis of health care expenses and outcomes in response to the question: What is the cost-effectiveness of intralesional and perilesional recombinant human epidermal growth factor (rhEGF) compared with hydrocolloid therapy in patients diagnosed with chronic venous insufficiency without infection in Colombia? METHODS A Markov model was used to determine cost effectiveness over a 5-year period, considering the perspective of the health system in Colombia. The study included patients aged >18 years diagnosed with chronic venous insufficiency and used clinical studies to calculate the probabilities of epithelialization, infection, recurrence, and mortality. RESULTS RhEGF is more expensive per unit than hydrocolloids, but it is proven to be effective at healing ulcers in 8 to 12 weeks, even in complex cases. Hydrocolloids, in contrast, typically require 29.5 weeks on average, and ≤46 weeks for complex cases. Despite the cost, rhEGF is more cost effective because it achieves results comparable with hydrocolloid therapy at a lower cost per additional quality-adjusted life-year. CONCLUSIONS Based on cost-effectiveness analysis, rhEGF is a superior alternative to hydrocolloids for treating venous ulcers in Colombia. Not only is it more affordable, but it also enhances patients' quality of life and streamlines the health care system's resource use.
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Affiliation(s)
- María Teresa Cacua Sánchez
- Health Services, Ambulatory Surgery Center, Hospital Occidente de Kennedy, Vascular Laboratory SURA, Bogotá, Colombia
| | - Ana María Botero
- Vascular Surgeon, Colombian Association for Vascular Surgery, Bogotá, CO
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Chin JD, Zhao L, Mayberry TG, Cowan BC, Wakefield MR, Fang Y. Photodynamic Therapy, Probiotics, Acetic Acid, and Essential Oil in the Treatment of Chronic Wounds Infected with Pseudomonas aeruginosa. Pharmaceutics 2023; 15:1721. [PMID: 37376169 PMCID: PMC10301549 DOI: 10.3390/pharmaceutics15061721] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Revised: 06/05/2023] [Accepted: 06/07/2023] [Indexed: 06/29/2023] Open
Abstract
As a prevalent medical problem that burdens millions of patients across the world, chronic wounds pose a challenge to the healthcare system. These wounds, often existing as a comorbidity, are vulnerable to infections. Consequently, infections hinder the healing process and complicate clinical management and treatment. While antibiotic drugs remain a popular treatment for infected chronic wounds, the recent rise of antibiotic-resistant strains has hastened the need for alternative treatments. Future impacts of chronic wounds are likely to increase with aging populations and growing obesity rates. With the need for more effective novel treatments, promising research into various wound therapies has seen an increased demand. This review summarizes photodynamic therapy, probiotics, acetic acid, and essential oil studies as developing antibiotic-free treatments for chronic wounds infected with Pseudomonas aeruginosa. Clinicians may find this review informative by gaining a better understanding of the state of current research into various antibiotic-free treatments. Furthermore. this review provides clinical significance, as clinicians may seek to implement photodynamic therapy, probiotics, acetic acid, or essential oils into their own practice.
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Affiliation(s)
- Jaeson D. Chin
- Department of Microbiology, Immunology & Pathology, Des Moines University, Des Moines, IA 50312, USA
| | - Lei Zhao
- The Department of Respiratory Medicine, The Second People’s Hospital of Hefei and Hefei Hospital Affiliated to Anhui Medical University, Hefei 230002, China
| | - Trenton G. Mayberry
- Department of Surgery, University of Missouri School of Medicine, Columbia, MO 65212, USA
| | - Braydon C. Cowan
- Department of Surgery, University of Missouri School of Medicine, Columbia, MO 65212, USA
| | - Mark R. Wakefield
- Department of Surgery, University of Missouri School of Medicine, Columbia, MO 65212, USA
- Ellis Fischel Cancer Center, University of Missouri, Columbia, MO 65212, USA
| | - Yujiang Fang
- Department of Microbiology, Immunology & Pathology, Des Moines University, Des Moines, IA 50312, USA
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Yang J, Liu X, Wang W, Chen Y, Liu J, Zhang Z, Wu C, Jiang X, Liang Y, Zhang J. Bioelectric fields coordinate wound contraction and re-epithelialization process to accelerate wound healing via promoting myofibroblast transformation. Bioelectrochemistry 2022; 148:108247. [PMID: 35994901 DOI: 10.1016/j.bioelechem.2022.108247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Revised: 08/09/2022] [Accepted: 08/15/2022] [Indexed: 11/02/2022]
Abstract
Electric fields (EFs) are thought to play a decisive role in wound healing. However, most studies focused on the effects of EF on single species of cells in vitro. Here, we aimed to investigate the coordination function of EFs on wound healing. Using a bamamini pig whole-layer wound model, we further evaluated the potential of EFs as a treatment modality by applying continuous and stable EF to the wound, and we found that EF promoted wound contraction and re-epithelialization in vivo, which accelerated wound healing. In vitro, we found that EFs significantly promoted the collective migration of HaCaT cells, guided HSF cells rearrangement, and promoted collagen secretion and myofibroblast transformation, and the electrotaxis of HaCaT cells was significantly enhanced on the collagen substrate and F-actin polarization at the leading edge of the cells was more pronounced. Overall, we determined that EF promotes wound contraction by promoting myofibrillar transformation, while accelerating the formation of collagen substrates, and the substrates could provide a good basis for electric field-guided re-epithelialization. EF may promote wound healing in multiple dimensions interaction and coordinate the whole process of wound healing. These findings provide support for the continued development of EF for wound treatment applications.
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Affiliation(s)
- Jinrui Yang
- Department of Plastic Surgery, State Key Laboratory of Trauma, Burns and Combined Injury, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, China
| | - Xiaoqiang Liu
- Department of Plastic Surgery, State Key Laboratory of Trauma, Burns and Combined Injury, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, China
| | - Wenping Wang
- Department of Plastic Surgery, State Key Laboratory of Trauma, Burns and Combined Injury, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, China
| | - Ying Chen
- Department of Plastic Surgery, State Key Laboratory of Trauma, Burns and Combined Injury, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, China
| | - Jie Liu
- Department of Plastic Surgery, State Key Laboratory of Trauma, Burns and Combined Injury, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, China
| | - Ze Zhang
- Department of Plastic Surgery, State Key Laboratory of Trauma, Burns and Combined Injury, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, China
| | - Chao Wu
- Department of Plastic Surgery, State Key Laboratory of Trauma, Burns and Combined Injury, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, China
| | - Xupin Jiang
- Department of Plastic Surgery, State Key Laboratory of Trauma, Burns and Combined Injury, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, China
| | - Yi Liang
- Department of Burn and Plastic Surgery, Army 73rd Group Military Hospital, China.
| | - JiaPing Zhang
- Department of Plastic Surgery, State Key Laboratory of Trauma, Burns and Combined Injury, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, China.
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Tetteh-Quarshie S, Blough ER, Jones CB. Exploring Dendrimer Nanoparticles for Chronic Wound Healing. FRONTIERS IN MEDICAL TECHNOLOGY 2022; 3:661421. [PMID: 35047918 PMCID: PMC8757741 DOI: 10.3389/fmedt.2021.661421] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2021] [Accepted: 04/12/2021] [Indexed: 12/16/2022] Open
Abstract
The United States spends billions of dollars to treat chronic wounds each year. Wound healing is complex in nature which involves several intricate multiphase processes that can be delayed for a number of reasons leading to the development of chronic wounds. Wound healing therapies range from topical preparations to surgical repair with treatment options that vary based on other underlying factors like co-infection, age, or co-morbidities such as diabetes. Historically, micelles and liposomes are some of the nanoparticle drug delivery systems explored to treat chronic wounds; however, recent data suggests that dendrimers have shown potential to rival these systems in treating chronic wounds as well as other diseases. This mini review examines advances in dendrimer nanoparticle drug delivery systems to treat chronic wounds.
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Affiliation(s)
- Samuel Tetteh-Quarshie
- Department of Pharmaceutical Science and Research, School of Pharmacy, Marshall University, Huntington, WV, United States
| | - Eric R Blough
- Department of Pharmaceutical Science and Research, School of Pharmacy, Marshall University, Huntington, WV, United States.,Department of Pharmacology, Physiology, and Toxicology, Joan C. Edwards School of Medicine, Marshall University, Huntington, WV, United States
| | - Cynthia B Jones
- Department of Pharmaceutical Science and Research, School of Pharmacy, Marshall University, Huntington, WV, United States
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Ruiz PBDO, Lima AFC. Custos diretos médios da assistência ambulatorial, hospitalar e domiciliar prestada aos pacientes com feridas crônicas. Rev Esc Enferm USP 2022. [DOI: 10.1590/1980-220x-reeusp-2022-0295pt] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
RESUMO Objetivo: Analisar os custos diretos médios da assistência ambulatorial, hospitalar e domiciliar prestada aos pacientes com feridas crônicas. Método: Pesquisa quantitativa, exploratório-descritiva, do tipo estudo de caso, realizada numa Unidade de Tratamento Integral de Ferida. Obtiveram-se os custos multiplicando-se o tempo despendido pelos profissionais pelo custo unitário da mão de obra da respectiva categoria, somando-se aos custos dos materiais e terapias tópicas. Resultados: Os custos da assistência ambulatorial corresponderam a US$4,25 (DP ± 7,60), da hospitalar a US$3,87 (DP ± 17,27) e da domiciliar a US$3,47 (DP ± 5,73). Nessas três modalidades, os custos diretos com os curativos e consultas médicas foram os mais representativos: US$7,76 (DP ± 9,46) e US$6,61 (DP ± 6,54); US$7,06 (DP ± 24,16) e US$15,60 (DP ± 0,00); US$4,09 (DP ± 5,28) e US$15,60 (DP ± 0,00), respectivamente. Conclusão Considerando a assistência integral aos pacientes com feridas crônicas, o custo direto médio total foi de US$10,28 (DP ± 17,21), sendo a modalidade ambulatorial a mais representativa na sua composição. Constatou-se diferença estatística significante (valor p = 0,000) entre os custos da assistência domiciliar e ambulatorial, domiciliar e hospitalar e ambulatorial e hospitalar.
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Ruiz PBDO, Lima AFC. Average direct costs of outpatient, hospital, and home care provided to patients with chronic wounds. Rev Esc Enferm USP 2022; 56:e20220295. [PMID: 36448569 PMCID: PMC10111378 DOI: 10.1590/1980-220x-reeusp-2022-0295en] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Accepted: 09/21/2022] [Indexed: 11/16/2022] Open
Abstract
ABSTRACT Objective: To analyze the average direct costs of outpatient, hospital, and home care provided to patients with chronic wounds. Method: Quantitative, exploratory-descriptive case study, carried out in a Comprehensive Wound Care Unit. Costs were obtained by multiplying the time spent by professionals by the unit cost of labor in the respective category, adding to the costs of materials and topical therapies. Results: Outpatient care costs corresponded to US$4.25 (SD ± 7.60), hospital care to US$3.87 (SD ± 17.27), and home care to US$3.47 (SD ± 5.73). In these three modalities, direct costs with dressings and medical consultations were the most representative: US$7.76 (SD ± 9.46) and US$6.61 (SD ± 6.54); US$7.06 (SD ± 24.16) and US$15.60 (SD ± 0.00); US$4.09 (SD ± 5.28) and US$15.60 (SD ± 0.00), respectively. Conclusion: Considering comprehensive care for patients with chronic wounds, the mean total direct cost was US$10.28 (SD ± 17.21), with the outpatient modality being the most representative in its composition. There was a statistically significant difference (p value = 0.000) between the costs of home and outpatient, home and hospital, and outpatient and hospital care.
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Abstract
Pressure ulcers (PU) are one of the most frequent hazards of long-term bedridden patients. With the continuous increase of aging, the number of long-term bedridden disabled and semi-disabled elderly people is increasing. At the same time, there is a serious shortage of professional pressure ulcer nursing staff. There is also a lack of flexible turning equipment for PU prevention. The research in the field of pressure ulcer prevention at home and abroad is carried out steadily, and the equipment for turning over by pneumatic or mechanical drive is developed. However, these devices often have insurmountable defects, such as complex structure, cost constraints, difficult control, weak body feeling, and so on. Under these circumstances, a set of pneumatic turnover mattresses based on clinical nursing methods have been developed. The mattress is divided into a turnover area and two support areas. The turnover airbag is linked with the support airbag to improve the patient’s comfort when passively turning over. The turnover amplitude and interval can be adjusted to provide a personalized turnover experience for bedridden patients. To improve the safety of the turning mattress during automatic turning, we also add a temperature sensor based on the principle of infrared reflection to monitor the status of bedridden patients, which can realize real-time temperature measurement, monitoring of getting out of bed and monitoring of the turning process.
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Moore Z, Avsar P, Wilson P, Mairghani M, O'Connor T, Nugent L, Patton D. Diabetic foot ulcers: treatment overview and cost considerations. J Wound Care 2021; 30:786-791. [PMID: 34644133 DOI: 10.12968/jowc.2021.30.10.786] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Affiliation(s)
- Zena Moore
- Professor of Nursing, Head of School of Nursing and Midwifery and Director of the Skin Wounds and Trauma Research Centre. RCSI University of Medicine and Health Sciences, Dublin; Adjunct Professor, Fakeeh College of Health Sciences, Jeddah, Saudi Arabia; Adjunct Professor, Faculty of Medicine, Nursing and Health Sciences, Monash University, Australia; Professor, Department of Public Health, Faculty of Medicine and Health Sciences, Ghent University, Belgium; Honorary Professor, Lida Institute, Shanghai, China; Visiting Professor, University of Wales, Cardiff, UK; Adjunct Professor, Griffith University, Australia
| | - Pinar Avsar
- Senior Postdoctoral Fellow. Skin Wounds and Trauma Research Centre. The Royal College of Surgeons in Ireland (RCSI), University of Medicine and Health Sciences, Dublin
| | - Pauline Wilson
- Skin, Wounds and Trauma Research Centre, School of Nursing and Midwifery. RCSI University of Medicine and Health Sciences, Dublin
| | - Maisoon Mairghani
- Skin, Wounds and Trauma Research Centre, School of Nursing and Midwifery. RCSI University of Medicine and Health Sciences, Dublin
| | - Tom O'Connor
- Director of Academic Affairs and Deputy Head of School, School of Nursing and Midwifery and Lead Researcher, Skin Wounds and Trauma Research Centre, RCSI University of Medicine and Health Sciences, Dublin; Honorary Professor, Lida Institute, Shanghai, China; Adjunct Professor, Fakeeh College of Health Sciences, Jeddah, Saudi Arabia; Adjunct Professor, Griffith University, Australia
| | - Linda Nugent
- Lecturer and Programme Director, School of Nursing and Midwifery. The Royal College of Surgeons in Ireland (RCSI), University of Medicine and Health Sciences, Dublin; Adjunct Assistant Professor, Fakeeh College of Health Sciences, Jeddah, Saudi Arabia
| | - Declan Patton
- Director of Nursing and Midwifery Research and Deputy Director of the Skin, Wounds and Trauma Research Centre, School of Nursing and Midwifery, RCSI University of Medicine and Health Sciences, Dublin; Adjunct Associate Professor, Fakeeh College of Health Sciences, Jeddah, Saudi Arabia; Honorary Senior Fellow, Faculty of Science, Medicine and Health, University of Wollongong, Australia; Adjunct Professor, Griffith University, Australia
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Graves N, Phillips CJ, Harding K. A narrative review of the epidemiology and economics of chronic wounds. Br J Dermatol 2021; 187:141-148. [PMID: 34549421 DOI: 10.1111/bjd.20692] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/26/2021] [Indexed: 12/11/2022]
Abstract
Chronic wounds have a debilitating effect on the quality of life of many individuals, and the large economic impact on health system budgets warrants greater attention in policy making and condition management than is currently evident. The aim of this narrative review is to summarize the nature and extent of the chronic wound problem that confronts health systems across the world. The first section is used to highlight the underlying epidemiology relating to chronic wounds, while the second explores the economic costs associated with them and the relative efficiency of measures designed to manage them.
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Affiliation(s)
- N Graves
- Health Services and Systems Research, Duke-NUS Medical School, Singapore
| | - C J Phillips
- Department of Public Health and Policy Studies, Swansea University, Swansea, UK
| | - K Harding
- Clinical Innovation Hub, Cardiff University, Cardiff, UK
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Selva-Sevilla C, Fernández-Ginés FD, Cortiñas-Sáenz M, Gerónimo-Pardo M. Cost-effectiveness analysis of domiciliary topical sevoflurane for painful leg ulcers. PLoS One 2021; 16:e0257494. [PMID: 34543330 PMCID: PMC8452083 DOI: 10.1371/journal.pone.0257494] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2021] [Accepted: 09/02/2021] [Indexed: 11/19/2022] Open
Abstract
Objectives The general anesthetic sevoflurane is being repurposed as a topical analgesic for painful chronic wounds. We conducted a Bayesian cost-effectiveness analysis (CEA) comparing the addition of domiciliary topical sevoflurane to conventional analgesics (SEVOFLURANE, n = 38) versus conventional analgesics alone (CONVENTIONAL, n = 26) for the treatment of nonrevascularizable painful leg ulcers in an outpatient Pain Clinic of a Spanish tertiary hospital. Methods We used real-world data collected from charts to conduct this CEA from a public healthcare perspective and with a one-year time horizon. Costs of analgesics, visits and admissions were considered, expressed in €2016. Analgesic effectiveness was measured with SPID (Sum of Pain Intensity Difference). A Bayesian regression model was constructed, including “treatment” and baseline characteristics for patients (“arterial hypertension”) and ulcers (“duration”, “number”, “depth”, “pain”) as covariates. The findings were summarized as a cost-effectiveness plane and a cost-effectiveness acceptability curve. One-way sensitivity analyses, a re-analysis excluding those patients who died or suffered from leg amputation, and an extreme scenario analysis were conducted to reduce uncertainty. Results Compared to CONVENTIONAL, SEVOFLURANE was associated with a 46% reduction in costs, and the mean incremental effectiveness (28.15±3.70 effectiveness units) was favorable to SEVOFLURANE. The estimated probability for SEVOFLURANE being dominant was 99%. The regression model showed that costs were barely influenced by any covariate, whereas effectiveness was noticeably influenced by “treatment”. All sensitivity analyses showed the robustness of the model, even in the extreme scenario analysis against SEVOFLURANE. Conclusions SEVOFLURANE was dominant over CONVENTIONAL as it was less expensive and much more effective.
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Affiliation(s)
- Carmen Selva-Sevilla
- Department of Applied Economics, Faculty of Economics, University of Castilla La Mancha, Albacete, Spain
| | | | - Manuel Cortiñas-Sáenz
- Unit of Pain—Department of Anesthesiology, Torrecárdenas Hospital Complex, Almería, Spain
| | - Manuel Gerónimo-Pardo
- Department of Anesthesiology, Complejo Hospitalario Universitario, Albacete, Spain
- * E-mail: ,
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Chen Y, Liang Y, Liu J, Yang J, Jia N, Zhu C, Zhang J. Optimizing microenvironment by integrating negative pressure and exogenous electric fields via a flexible porous conductive dressing to accelerate wound healing. Biomater Sci 2021; 9:238-251. [PMID: 33184620 DOI: 10.1039/d0bm01172j] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Wound healing is a complex and sequential biological process that involves multiple stages. Current treatments for nonhealing or chronic wounds are unsatisfactory as they exert a single effect on one specific activity. Herein, we constructed a silver nanowire (AgNW)-based, three-dimensional (3D), porous foam dressing that is flexible and conductive. This conductive foam dressing was composed of AgNWs modified with a stable hydrophobic coating and porous polyurethane (PU), providing a skeleton to support the 3D conductive networks. The AgNWs-PU foam dressing exhibited favorable biocompatibility, outstanding electrical properties, excellent bending-compression durability, and long-term stability under wet conditions, making it suitable for wound treatment. Via the conductive foam dressing, negative pressure and exogenous wound directional electric fields (EFs) could be integrated for simultaneous implementation, and the artificial jointly constructed microenvironment promoted wound healing in a system. This novel "all-in-one" device presented intrinsic multifunctionality, including the drainage of pus and necrotic tissue, mitigation of inflammation, promotion of cell proliferation, direction of keratinocyte migration, and induction of angiogenesis. An immunohistochemical assay and western blot analysis illustrated that the angiogenesis and cell proliferation pathways in the tissue were significantly activated when this novel therapy was adopted. More importantly, the practical performance of this "all-in-one" device was demonstrated by assessment of full-thickness defect wounds in model pigs. Comparing the percentage of residual wound area after administration of traditional treatment (25.82 ± 3.52%) and the novel treatment (3.07 ± 1.23%) demonstrated the promising applications of this novel treatment in clinical wound healing.
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Affiliation(s)
- Ying Chen
- Department of Plastic Surgery, State Key Laboratory of Trauma, Burns and Combined Injury, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, 400038, China.
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Cruz MA, Araujo TA, Avanzi IR, Parisi JR, de Andrade ALM, Rennó ACM. Collagen from Marine Sources and Skin Wound Healing in Animal Experimental Studies: a Systematic Review. MARINE BIOTECHNOLOGY (NEW YORK, N.Y.) 2021; 23:1-11. [PMID: 33404918 DOI: 10.1007/s10126-020-10011-6] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Accepted: 11/29/2020] [Indexed: 06/12/2023]
Abstract
Collagen (Col) from marine organisms has been emerging as an important alternative for commercial Col and it has been considered highly attractive by the industry. Despite the positive effects of Col from marine origin, there is still limited understanding of the effects of this natural biomaterial in the process of wound healing in animal studies. In this context, the purpose of this study was to perform a systematic review of the literature to examine the effects of Col from different marine species in the process of skin tissue healing using experimental models of skin wound. The search was carried out according to the orientations of Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA), and the descriptors of the Medical Subject Headings (MeSH) were defined: "marine collagen," "spongin," "spongin," "skin," and "wound." A total of 42 articles were retrieved from the databases PubMed and Scopus. After the eligibility analyses, this review covers the different marine sources of Col reported in 10 different papers from the beginning of 2011 through the middle of 2019. The results were based mainly on histological analysis and it demonstrated that Col-based treatment resulted in a higher deposition of granulation tissue, stimulation of re-epitalization and neoangiogenesis and increased amount of Col of the wound, culminating in a more mature morphological aspect. In conclusion, this review demonstrates that marine Col from different species presented positive effects on the process of wound skin healing in experimental models used, demonstrating the huge potential of this biomaterial for tissue engineering proposals.
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Affiliation(s)
- Matheus Almeida Cruz
- Department of Biosciences, Federal University of São Paulo (UNIFESP), Lab 342, 136 Silva Jardim Street, Santos, SP, 11015020, Brazil
| | - Tiago Akira Araujo
- Department of Biosciences, Federal University of São Paulo (UNIFESP), Lab 342, 136 Silva Jardim Street, Santos, SP, 11015020, Brazil
| | - Ingrid Regina Avanzi
- Department of Biosciences, Federal University of São Paulo (UNIFESP), Lab 342, 136 Silva Jardim Street, Santos, SP, 11015020, Brazil
- São Paulo State Faculty of Technology (FATEC), 350 Senador Feijó Avenue, Santos, SP, 11015502, Brazil
| | - Julia Risso Parisi
- Department of Biosciences, Federal University of São Paulo (UNIFESP), Lab 342, 136 Silva Jardim Street, Santos, SP, 11015020, Brazil
- Department of Physical Therapy, Federal University of São Carlos (UFSCar), km 235 Washington Luís Road, São Carlos, SP, 13565905, Brazil
| | - Ana Laura Martins de Andrade
- Department of Physical Therapy, Federal University of São Carlos (UFSCar), km 235 Washington Luís Road, São Carlos, SP, 13565905, Brazil
| | - Ana Claudia Muniz Rennó
- Department of Biosciences, Federal University of São Paulo (UNIFESP), Lab 342, 136 Silva Jardim Street, Santos, SP, 11015020, Brazil.
- Department of Physical Therapy, Federal University of São Carlos (UFSCar), km 235 Washington Luís Road, São Carlos, SP, 13565905, Brazil.
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13
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Raepsaet C, Fourie A, Van Hecke A, Verhaeghe S, Beeckman D. Management of incontinence-associated dermatitis: A systematic review of monetary data. Int Wound J 2020; 18:79-94. [PMID: 33236846 PMCID: PMC7948709 DOI: 10.1111/iwj.13496] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2020] [Revised: 08/12/2020] [Accepted: 08/13/2020] [Indexed: 12/13/2022] Open
Abstract
The objective was to systematically review monetary data related to management of incontinence‐associated dermatitis (IAD) in an adult population. Six electronic databases were searched: MEDLINE, CINAHL, Web of Science, EMBASE, The Cochrane Library and EconLit. The search string combined index terms and text words related to IAD and monetary data. The quality of the articles was assessed using the consensus on Health Economic Criteria. Results were synthesised narratively because of methodological heterogeneity. Nine studies were included. Only direct medical costs were reported. The product cost per application for prevention ranged between $0.05 and $0.52, and for treatment between $0.20 and $0.35. The product cost per patient/day for prevention ranged between $0.23 and $20.17. The product cost of IAD prevention and treatment per patient/day ranged between $0.57 and $1.08. The cost to treat IAD did not consider the treatment of secondary infection. The calculation of labour cost and total cost differed considerably between studies. Summarising monetary data is a challenge because of heterogeneity in currencies, settings, samples, time horizons, health‐ and cost outcome valuation, IAD definition and measurements, and included costs. Procedures for health economic evaluations are to be clarified to guarantee valid interpretation and comparison with other studies.
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Affiliation(s)
- Charlotte Raepsaet
- Skin Integrity Research Group (SKINT), University Centre for Nursing and Midwifery, Department of Public Health and Primary Care, Ghent University, Ghent, Belgium
| | - Anika Fourie
- Skin Integrity Research Group (SKINT), University Centre for Nursing and Midwifery, Department of Public Health and Primary Care, Ghent University, Ghent, Belgium
| | - Ann Van Hecke
- Skin Integrity Research Group (SKINT), University Centre for Nursing and Midwifery, Department of Public Health and Primary Care, Ghent University, Ghent, Belgium
| | - Sofie Verhaeghe
- Skin Integrity Research Group (SKINT), University Centre for Nursing and Midwifery, Department of Public Health and Primary Care, Ghent University, Ghent, Belgium
| | - Dimitri Beeckman
- Skin Integrity Research Group (SKINT), University Centre for Nursing and Midwifery, Department of Public Health and Primary Care, Ghent University, Ghent, Belgium.,School of Health Sciences, Örebro University, Örebro, Sweden.,School of Nursing & Midwifery, Royal College of Surgeons in Ireland (RCSI), Dublin, Ireland.,Research Unit of Plastic Surgery, Department of Clinical Research, Faculty of Health Sciences, Vejle, Denmark.,School of Nursing and Midwifery, Monash University, Melbourne, Australia
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Selva-Sevilla C, Conde-Montero E, Gerónimo-Pardo M. Bayesian Regression Model for a Cost-Utility and Cost-Effectiveness Analysis Comparing Punch Grafting Versus Usual Care for the Treatment of Chronic Wounds. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E3823. [PMID: 32481604 PMCID: PMC7313055 DOI: 10.3390/ijerph17113823] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Revised: 05/25/2020] [Accepted: 05/26/2020] [Indexed: 01/21/2023]
Abstract
Punch grafting is a traditional technique used to promote epithelialization of hard-to-heal wounds. The main purpose of this observational study was to conduct a cost-utility analysis (CUA) and a cost-effectiveness analysis (CEA) comparing punch grafting (n = 46) with usual care (n = 34) for the treatment of chronic wounds in an outpatient specialized wound clinic from a public healthcare system perspective (Spanish National Health system) with a three-month time horizon. CUA outcome was quality-adjusted life years (QALYs) calculated from EuroQoL-5D, whereas CEA outcome was wound-free period. One-way sensitivity analyses, extreme scenario analysis, and re-analysis by subgroups were conducted to fight against uncertainty. Bayesian regression models were built to explore whether differences between groups in costs, wound-free period, and QALYs could be explained by other variables different to treatment. As main results, punch grafting was associated with a reduction of 37% in costs compared to usual care, whereas mean incremental utility (0.02 ± 0.03 QALYs) and mean incremental effectiveness (7.18 ± 5.30 days free of wound) were favorable to punch grafting. All sensitivity analyses proved the robustness of our models. To conclude, punch grafting is the dominant alternative over usual care because it is cheaper and its utility and effectiveness are greater.
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Affiliation(s)
- Carmen Selva-Sevilla
- Department of Applied Economy, Facultad de Ciencias Económicas y Empresariales de Albacete, Universidad de Castilla La Mancha, Plaza de la Universidad 1, 02071 Albacete, Spain
| | - Elena Conde-Montero
- Department of Dermatology, Hospital Universitario Infanta Leonor, Avenida Gran Vía del Este 80, 28031 Madrid, Spain;
| | - Manuel Gerónimo-Pardo
- Department of Anesthesiology, Complejo Hospitalario Universitario de Albacete, Calle Hermanos Falcó 37, 02006 Albacete, Spain;
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Al-Gharibi KA, Sharstha S, Al-Faras MA. Cost-Effectiveness of Wound Care: A concept analysis. Sultan Qaboos Univ Med J 2019; 18:e433-e439. [PMID: 30988960 DOI: 10.18295/squmj.2018.18.04.002] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2018] [Revised: 07/09/2018] [Accepted: 08/02/2018] [Indexed: 11/16/2022] Open
Abstract
This review aimed to analyse the concept of cost-effectiveness within the context of chronic wound care using Walker and Avant's approach. The Cumulative Index to Nursing and Allied Health Literature® (EBSCO Information Services, Ipswich, Massachusetts, USA), MEDLINE® (National Library of Medicine, Bethesda, Maryland, USA) and Nursing & Allied Health® (ProQuest LLC, Ann Arbor, Michigan, USA) databases were searched using a combination of keywords. A total of 18 peer-reviewed articles were identified. In wound care, defining attributes for the concept of cost-effectiveness encompassed treatments which were both effective and economical. Four antecedents were identified, including the type of wound, care setting, type of dressing and patient-related characteristics. The consequences of cost-effective wound care were patient prognosis, quality of life, the economic burden on the patient and healthcare system and cost-savings. These findings will hopefully help to standardise cost-effectiveness terminology among nursing professionals in various healthcare settings.
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Affiliation(s)
| | - Sajana Sharstha
- College of Nursing & Health Professions, Valparaiso University, Valparaiso, Indiana, USA
| | - Maria A Al-Faras
- College of Nursing & Health Professions, Valparaiso University, Valparaiso, Indiana, USA
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16
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Autologous bone marrow-derived cells for venous leg ulcers treatment: a pilot study. Cytotherapy 2019; 21:189-199. [PMID: 30700393 DOI: 10.1016/j.jcyt.2019.01.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2018] [Revised: 12/30/2018] [Accepted: 01/08/2019] [Indexed: 01/17/2023]
Abstract
BACKGROUND Chronic venous leg ulcers (VLUs) are a common problem in clinical practice and available treatments are not satisfactory. The use of adjuvant therapies in combination with lower limb compression may lead to improved healing rates. Chronic wounds are candidates for new strategies in the emergent field of regenerative medicine. Bone marrow-derived cells (BMDCs) contain cells and secrete cytokines known to participate in wound healing. Thus, BMDC therapy seems a logical strategy for the treatment of chronic wounds. Our objective was to evaluate feasibility, safety and initial clinical outcome of autologous BMDC therapy associated with standard treatment in patients with VLUs. METHODS We conducted an open-label, single-arm, prospective pilot clinical trial in four patients with six chronic VLUs. The study protocol was approved by the institutional and national review boards and ethics committees. Bone marrow was harvest, processed and then administered by multiple injections into the ulcers. All patients received standard treatment and non-healing characteristics of the VLUs were confirmed at study entry. RESULTS Ulcer size and wound pain evaluated 12 months after BMDC treatment were significantly reduced (P < 0.05). BMDC treatment was safe and well tolerated in long-term follow-up. DISCUSSION Despite the low number of patients studied, our results showed that autologous BMDC treatment could be a useful, feasible and safe procedure to enhance ulcer healing. However, randomized controlled trials with more patients are needed to address this question and translate this approach into clinical practice.
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Cheng Q, Graves N, Pacella RE. Economic Evaluations of Guideline-Based Care for Chronic Wounds: a Systematic Review. APPLIED HEALTH ECONOMICS AND HEALTH POLICY 2018; 16:633-651. [PMID: 29968020 DOI: 10.1007/s40258-018-0403-9] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
OBJECTIVES The aim of this study was to review all published economic evaluations of guideline-based care for chronic wounds and to assess how useful these studies are for decision making in health services. METHODS Embase, PubMed, Scopus, Health Technology Assessment (HTA) and National Health Service Economic Evaluation Database (NHS EED) were searched on April 16th, 2018. We included studies that evaluated the economic impact and health outcomes associated with implementing evidence-based guidelines as a bundle of care for the prevention and/or treatment of chronic wounds. Information was extracted from each eligible study and organized by the type of chronic wound. The quality of published economic evaluation studies was assessed using the Consolidated Health Economic Evaluation Reporting Standards (CHEERS). RESULTS A total of 24 economic evaluation studies met the inclusion criteria, of which 12 applied decision analytic models. The compliance with the CHEERS checklist ranged between 43 and 83%. LIMITATIONS We may have missed some economic evaluation studies despite the use of broad search terms. The quality assessment was conducted based on judgment. Using the CHEERS checklist may reflect the way evaluations were reported rather than conducted. CONCLUSIONS AND IMPLICATIONS OF KEY FINDINGS We found that guideline-based care may be cost-saving or cost-effective in most circumstances. The quality and usefulness of reviewed studies for decision making were variable. Better information and higher-quality economic evaluations will increase decision makers' confidence to promote guideline-based care. SYSTEMATIC REVIEW REGISTRATION NUMBER PROSPERO CRD42017051859.
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Affiliation(s)
- Qinglu Cheng
- Australian Centre for Health Services Innovation (AusHSI), Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, QLD, Australia.
| | - Nicholas Graves
- Australian Centre for Health Services Innovation (AusHSI), Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, QLD, Australia
| | - Rosana E Pacella
- Australian Centre for Health Services Innovation (AusHSI), Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, QLD, Australia
- Wound Management Innovation Cooperative Research Centre, Brisbane, QLD, Australia
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Antigen-Mediated, Macrophage-Stimulated, Accelerated Wound Healing Using α-Gal Nanoparticles. Ann Plast Surg 2018; 80:S196-S203. [DOI: 10.1097/sap.0000000000001360] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
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Moreno-Eutimio MA, Espinosa-Monroy L, Orozco-Amaro T, Torres-Ramos Y, Montoya-Estrada A, Jose Hicks J, Rodríguez-Ayala E, Moral PD, Moreno J, Cueto-García J. Enhanced healing and anti-inflammatory effects of a carbohydrate polymer with zinc oxide in patients with chronic venous leg ulcers: preliminary results. Arch Med Sci 2018; 14:336-344. [PMID: 29593807 PMCID: PMC5868658 DOI: 10.5114/aoms.2016.59851] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2015] [Accepted: 08/01/2015] [Indexed: 12/25/2022] Open
Abstract
INTRODUCTION Insufficient wound healing related to chronic inflammation of chronic venous leg ulcers (CVUs) represents an important public health problem. The aim of this study was to evaluate the effects of a carbohydrate polymer with zinc oxide therapy on CVUs. MATERIAL AND METHODS Forty patients with CVUs were recruited for this study and were divided into a study group and control group. Patients In the study group were instructed to use venous compression treatment andtopical carbohydrate polymer with zinc oxide twice daily, while patients In the control group were treated with only venous compression treatment. All patients were followed up for 8 weeks. Peripheral blood samples and biosy tissue specimens were obtained at the initiation of treatment and after 8 weeks to assess serum levels of inflammatory cytokines as well as the percentage of leukocytes, T-helper cells, cytotoxic-T cells, macrophages and endothelial cells in the biopsy tissue using flow cytometry. RESULTS A significantly greater reduction in the mean percentage ulcer area from baseline to eight weeks was observed in the study group (up to 40% for large ulcers). Furthermore, the patients in the study group had reduced systemic levels of the pro-inflammatory cytokines IL-8 (p = 0.0028) and IL-6 (p = 0.0302), fewer total CD45+ cells (p = 0.0038) and more CD31+ cells (p = 0.045) present in ulcer biopsies compared to the control group. CONCLUSIONS The carbohydrate polymer with zinc oxide treatment with venous compression enhances healing of CVUs and improves quality of life due, in part, to its anti-inflammatory properties.
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Affiliation(s)
| | - Lorena Espinosa-Monroy
- Wound and Ostomy Clinic, Division of Research, Hospital Juarez de México, Ministry of Health, Mexico City, Mexico
| | - Tania Orozco-Amaro
- Immunobiology Laboratory, Hospital Juarez de México, Ministry of Health, Mexico City, Mexico
| | - Yessica Torres-Ramos
- Biochemistry Department, National Institute of Perinatology, Ministry of Health, Mexico City, Mexico
| | - Araceli Montoya-Estrada
- Biochemistry Department, National Institute of Perinatology, Ministry of Health, Mexico City, Mexico
| | - Juan Jose Hicks
- Health Research Policies, Coordinating Commission of National Health Institutes and Highly Specialized Hospitals, Mexico City, Mexico
| | | | - Pamela Del Moral
- Health Sciences Faculty, Anahuac University, State of Mexico, Mexico
| | - Jose Moreno
- Immunobiology Laboratory, Hospital Juarez de México, Ministry of Health, Mexico City, Mexico
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Järbrink K, Ni G, Sönnergren H, Schmidtchen A, Pang C, Bajpai R, Car J. The humanistic and economic burden of chronic wounds: a protocol for a systematic review. Syst Rev 2017; 6:15. [PMID: 28118847 PMCID: PMC5259833 DOI: 10.1186/s13643-016-0400-8] [Citation(s) in RCA: 257] [Impact Index Per Article: 36.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2016] [Accepted: 12/19/2016] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Chronic non-healing wounds present a substantial economic burden to healthcare system; significant reductions in quality of life for those affected, and precede often serious events such as limp amputations or even premature deaths. This burden is also likely to increase with a larger proportion of elderly and increasing prevalence of life-style diseases such as obesity and diabetes. Reviews of the evidence on the burden of illness associated with chronic wounds have not been comprehensive in scope and have not provided an assessment of the distribution of the health care costs across categories of resource use. METHODS/DESIGN This study is a systematic review of multiple databases for studies on adult patients with chronic wounds and with the primary objective to assess the impact on health-related quality of life by category of ulcers, and associated direct and indirect costs. Eligible studies will primary be empirical studies evaluating, describing or comparing measurement of quality of life and economic impact. Two reviewers will independently screen titles and abstracts and select studies involving adults with chronic wounds. These investigators will also independently extract data using a pre-designed data extraction form. Differences in applied methodologies and uncertainties will clearly be accounted for. Conservative valuations of costs and impact on health-related quality of life will be prioritised. Variations that may depend on age distribution, the categorisation of ulcer, healthcare system etc. will be described clearly. DISCUSSION The proposed systematic review will yield a comprehensive assessment of the humanistic and economic burden of chronic wounds in an adult population. A better understanding of the humanistic and economic burden of chronic wounds is essential for policy and planning purposes, to monitor trends in disease burden and not at least in order to estimate the real-world cost-effectiveness of new treatments and therapies. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42016037496.
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Affiliation(s)
- Krister Järbrink
- Centre for Population Health Sciences (CePHaS), Lee Kong Chian School of Medicine, Nanyang Technological University, 59 Nanyang Drive, Experimental Medicine Building, Singapore, 636921 Singapore
| | - Gao Ni
- Centre for Population Health Sciences (CePHaS), Lee Kong Chian School of Medicine, Nanyang Technological University, 59 Nanyang Drive, Experimental Medicine Building, Singapore, 636921 Singapore
| | - Henrik Sönnergren
- Department of Dermatology, Skåne University Hospital, Lasarettsgatan 15, 221 85 Lund, Sweden
| | - Artur Schmidtchen
- Dermatology and Innate Immunity Laboratory, Lee Kong Chian School of Medicine, Nanyang Technological University, 59 Nanyang Drive, Experimental Medicine Building, Singapore, 636921 Singapore
| | - Caroline Pang
- Medical Library, Lee Kong Chian School of Medicine, 11 Mandalay Road, Singapore, 308232 Singapore
| | - Ram Bajpai
- Centre for Population Health Sciences (CePHaS), Lee Kong Chian School of Medicine, Nanyang Technological University, 59 Nanyang Drive, Experimental Medicine Building, Singapore, 636921 Singapore
| | - Josip Car
- Centre for Population Health Sciences (CePHaS), Lee Kong Chian School of Medicine, Nanyang Technological University, 59 Nanyang Drive, Experimental Medicine Building, Singapore, 636921 Singapore
- Global eHealth Unit, Department of Primary Care and Public Health, School of Public Health, Imperial College London, 3rd Floor Reynolds Building, St Dunstan’s Road, London, W6 8RP UK
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Norman RE, Gibb M, Dyer A, Prentice J, Yelland S, Cheng Q, Lazzarini PA, Carville K, Innes-Walker K, Finlayson K, Edwards H, Burn E, Graves N. Improved wound management at lower cost: a sensible goal for Australia. Int Wound J 2016; 13:303-16. [PMID: 26634882 PMCID: PMC7949577 DOI: 10.1111/iwj.12538] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2015] [Revised: 09/18/2015] [Accepted: 10/07/2015] [Indexed: 12/18/2022] Open
Abstract
Chronic wounds cost the Australian health system at least US$2·85 billion per year. Wound care services in Australia involve a complex mix of treatment options, health care sectors and funding mechanisms. It is clear that implementation of evidence-based wound care coincides with large health improvements and cost savings, yet the majority of Australians with chronic wounds do not receive evidence-based treatment. High initial treatment costs, inadequate reimbursement, poor financial incentives to invest in optimal care and limitations in clinical skills are major barriers to the adoption of evidence-based wound care. Enhanced education and appropriate financial incentives in primary care will improve uptake of evidence-based practice. Secondary-level wound specialty clinics to fill referral gaps in the community, boosted by appropriate credentialing, will improve access to specialist care. In order to secure funding for better services in a competitive environment, evidence of cost-effectiveness is required. Future effort to generate evidence on the cost-effectiveness of wound management interventions should provide evidence that decision makers find easy to interpret. If this happens, and it will require a large effort of health services research, it could be used to inform future policy and decision-making activities, reduce health care costs and improve patient outcomes.
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Affiliation(s)
- Rosana E Norman
- Institute of Health and Biomedical Innovation, Queensland University of Technology, Kelvin Grove, QLD, Australia
- Wound Management Innovation Cooperative Research Centre, Brisbane, QLD, Australia
| | - Michelle Gibb
- Wound Management Innovation Cooperative Research Centre, Brisbane, QLD, Australia
| | - Anthony Dyer
- Wound Management Innovation Cooperative Research Centre, Brisbane, QLD, Australia
| | | | | | - Qinglu Cheng
- Institute of Health and Biomedical Innovation, Queensland University of Technology, Kelvin Grove, QLD, Australia
| | - Peter A Lazzarini
- Allied Health Research Collaborative, Metro North Hospital and Health Service, Queensland Health, Brisbane, QLD, Australia
- School of Clinical Sciences, Queensland University of Technology, Brisbane, QLD, Australia
| | - Keryln Carville
- Silver Chain Group, Perth, WA, Australia
- School of Nursing, Midwifery and Paramedicine, Curtin University, Perth, WA, Australia
| | - Karen Innes-Walker
- Institute of Health and Biomedical Innovation, Queensland University of Technology, Kelvin Grove, QLD, Australia
| | - Kathleen Finlayson
- Institute of Health and Biomedical Innovation, Queensland University of Technology, Kelvin Grove, QLD, Australia
| | - Helen Edwards
- Institute of Health and Biomedical Innovation, Queensland University of Technology, Kelvin Grove, QLD, Australia
- Wound Management Innovation Cooperative Research Centre, Brisbane, QLD, Australia
| | - Edward Burn
- Institute of Health and Biomedical Innovation, Queensland University of Technology, Kelvin Grove, QLD, Australia
| | - Nicholas Graves
- Institute of Health and Biomedical Innovation, Queensland University of Technology, Kelvin Grove, QLD, Australia
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Poursamar SA, Hatami J, Lehner AN, da Silva CL, Ferreira FC, Antunes APM. Potential application of gelatin scaffolds prepared throughin situgas foaming in skin tissue engineering. INT J POLYM MATER PO 2016. [DOI: 10.1080/00914037.2015.1119688] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
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The cost of prevention and treatment of pressure ulcers: A systematic review. Int J Nurs Stud 2015; 52:1754-74. [DOI: 10.1016/j.ijnurstu.2015.06.006] [Citation(s) in RCA: 250] [Impact Index Per Article: 27.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2014] [Revised: 06/12/2015] [Accepted: 06/16/2015] [Indexed: 11/20/2022]
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