scholarly journals Customized vacuum assisted closure therapy of wounds as a simple and cost-effective technique of wound closure-a prospective observational study from underdeveloped world

2021 ◽  
Author(s):  
Mushtaq A. Mir ◽  
Tajdin Wani ◽  
Tahir Saleem Khan ◽  
Syed Mushtaq Ahmad Shah ◽  
Ravi Kumar ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Cost Effective ◽  
Conventional Technique ◽  
Lower Limbs ◽  
Vacuum Assisted Closure ◽  
Vac Therapy ◽  
Secondary Intention ◽  
Cost Effective Technique ◽  
Fall From Height ◽  
Flap Cover

Background: Aim of the study was to study the efficacy and cost-effectiveness of indigenously designed customized vacuum assisted closure (VAC) of wounds in our patients. The management of difficult to heal wounds has been the main force that led to the development of advanced gadgets for their management. The technique of vacuum assisted closure has revolutionized the management of difficult to heal wounds and delivers better results as compared to conventional technique. Our aim was to assess the efficacy and cost effectiveness of customized VAC therapy.Methods: This prospective study was conducted in the department of surgery and allied specialties, GMC Srinagar, from June 2018 and September 2020. During this period, 80 patients were subjected to VAC therapy and were included in this study.Results: VAC dressing was used in 80 patients. 55 were males and 25 were females. Most of the wounds in our study were located over lower limbs (70%). RTA was the most common mode of injury followed by fall from height. After the VAC therapy, 78.8% patients were managed by STSG, 11.3% by flap cover, 6.3% by secondary suturing and 3.8% healed by secondary intention. Pain was experienced by 30% of the patients, 7.5% had hypoalbuminemia, 3.8% had surrounding skin maceration. The average total cost of the VAC therapy was 863.13 (±399.82) Indian rupees (11.76 USD). The mean duration of hospital stay for our patients was 22 days.Conclusions: Customized VAC Therapy has revolutionary potential in the management of the difficult to treat wounds as far as its safety, speed and cost effectiveness is considered especially in a setup of poor income nations like ours.

scholarly journals Cost Effectiveness of Vacuum-Assisted Closure and Its Modifications: A Review

2013 ◽  
Vol 2013 ◽  
pp. 1-5 ◽  
Author(s):  
Akhlak Hussain ◽  
Kuldip Singh ◽  
Mohinder Singh
Keyword(s):  
Cost Effectiveness ◽  
Negative Pressure ◽  
Cost Effective ◽  
General Category ◽  
Vacuum Assisted Closure ◽  
Pressure Therapy ◽  
Vac Therapy ◽  
Secondary Wound Healing ◽  
The Cost ◽  
Vacuum Assisted Closure Therapy

Negative topical pressure, the general category to which the trademarked VAC therapy belongs, is not a new concept in wound therapy. It is also called subatmospheric pressure therapy, vacuum sealing, vacuum-assisted closure therapy, vacuum pack therapy, and sealing aspirative therapy. The VAC therapy system is trademarked by Kinetic Concepts, Inc., or KCI. It was first reported in 1997. The aim of the procedure is to use negative pressure to create suction, which drains the wound of exudate (i.e., fluid, cells, and cellular waste that has escaped from blood vessels and seeped into tissue) and influences the shape and growth of the surface tissues in a way that helps healing. Negative-pressure therapy for the closure of wounds accelerates secondary wound healing. High cost is still a hindrance in its use in developing nations. Many modifications were tried, but their efficacy is yet to be proved. In reality, this method is quite cost effective. It is only the lack of understanding and adequate setup which makes this method hard to use. The main objective of this paper is to focus on the cost effectiveness of VAC and its modifications. We want to emphasize the importance of homemade NPT and the use of simple suction devices.

scholarly journals Cost-utility analysis of standard dressing compared with incisional negative-pressure wound therapy among patients with closed surgical wounds following major trauma to the lower limb

2020 ◽  
Vol 102-B (8) ◽  
pp. 1072-1081
Author(s):  
May E. Png ◽  
Jason J. Madan ◽  
Melina Dritsaki ◽  
Juul Achten ◽  
Nick Parsons ◽  
...  
Keyword(s):  
Sensitivity Analysis ◽  
Economic Evaluation ◽  
Cost Effectiveness ◽  
Negative Pressure Wound Therapy ◽  
Major Trauma ◽  
Cost Effective ◽  
Cost Utility ◽  
Lower Limbs ◽  
Wound Therapy ◽  
Surgical Wounds

Aims To compare the cost-utility of standard dressing with incisional negative-pressure wound therapy (iNPWT) in adults with closed surgical wounds associated with major trauma to the lower limbs. Methods A within-trial economic evaluation was conducted from the UK NHS and personal social services (PSS) perspective based on data collected from the Wound Healing in Surgery for Trauma (WHiST) multicentre randomized clinical trial. Health resource utilization was collected over a six-month post-randomization period using trial case report forms and participant-completed questionnaires. Cost-utility was reported in terms of incremental cost per quality-adjusted life year (QALY) gained. Sensitivity analysis was conducted to test the robustness of cost-effectiveness estimates while uncertainty was handled using confidence ellipses and cost-effectiveness acceptability curves. Results The incremental cost of standard dressing versus iNPWT over six months was £2,037 (95% confidence interval (CI) £349 to £3,724). There was an insignificant increment in QALYs gained in the iNPWT group (0.005, 95% CI -0.018 to 0.028). The probability of iNPWT being cost-effective at £20,000 per QALY was 1.9%. The results remained robust in the sensitivity analysis. Conclusion The within-trial economic evaluation suggests that iNPWT is unlikely to be a cost-effective alternative to standard dressing in adults with closed surgical wounds to their lower limbs. Cite this article: Bone Joint J 2020;102-B(8):1072–1081.

scholarly journals Outcome analysis of vacuum assisted closure therapy in patients with open wounds

2017 ◽  
Vol 3 (6) ◽  
pp. 1132
Author(s):  
Ravi Kant Jain ◽  
Danish Mohammad ◽  
Pranav Mahajan ◽  
Tanveer Sheikh ◽  
Awyay Rege
Keyword(s):  
Healing Process ◽  
Good Alternative ◽  
Lower Limbs ◽  
Outcome Analysis ◽  
Patient Acceptance ◽  
Vacuum Assisted Closure ◽  
Vac Therapy ◽  
Short Course ◽  
Severe Infections ◽  
Short Time

<p class="abstract"><strong>Background:</strong> <span lang="EN-IN">Vacuum assisted Closure (VAC) of wound is a recent trend and proven method of fast and better healing of wounds. The basic concept is the removal of blood and serous collection from the wound site with negative pressure and promoting the healing process rapidly by altering the local microcellular environment.</span><span lang="EN-IN">The objective of the study was to show the efficacy of healing process in open wounds treated by VAC method of dressing.</span></p><p class="abstract"><strong>Methods:</strong> <span lang="EN-IN">In this prospective study, total of 50 patients with </span><span lang="EN-IN">upper and lower limbs non-healing open wounds were recruited. Before the application of VAC, surgical debridement was performed to remove all the devitalized necrotic tissues and the wound was packed with povodine iodine. Prior to and at the end of VAC dressing, wound dimensions were noted</span>.<strong></strong></p><p class="abstract"><strong>Results:</strong> <span lang="EN-IN">Patients mean age was 46.72±7.63 years and out of which 42 patients (84%) were males and 8 patients (16%) were females. All patients had suffered an acute trauma. VAC therapy was applied through continuous or intermittent suction on wounds and dressing were changed every second or third day. After application of VAC therapy all wounds showed improvement, which were indicated by presence of healthy granulation tissue, absence of necrotic tissue and subsequent wound closure. </span></p><p class="abstract"><strong>Conclusions:</strong> <span lang="EN-IN">VAC dressing in an open wound is an efficient and safe adjunct to treat severe infections and may be a good alternative to treat the open wounds in selected patients. Short time intervals between VAC changes and short course of therapy result in good patient acceptance. This method is recommended for all the types of non-healing wounds management.</span></p>

Performance Evaluation of Reflective Crack Mitigation Techniques for Soil-Cement Bases

2020 ◽  
Vol 2674 (11) ◽  
pp. 901-914
Author(s):  
Mohammad Reza-Ul-Karim Bhuyan ◽  
Mohammad Jamal Khattak
Keyword(s):  
Cost Effectiveness ◽  
Large Scale ◽  
Cost Effective ◽  
Pavement Management ◽  
Crack Control ◽  
Soil Cement ◽  
Chip Seal ◽  
Effective Option ◽  
Cost Effective Technique ◽  
Two Parameters

The Louisiana Department of Transportation and Development (DOTD), U.S., has been using chip seal as an interlayer over cement stabilized base courses over the last several years to mitigate the reflective cracking for flexible pavements. Furthermore, DOTD is also changing the soil-cement base type from traditional cement stabilized design (CSD) to cement treated design (CTD) as another technique to control reflective cracks. There have been no large-scale studies conducted to determine the effectiveness of chip seal interlayer over CSD bases or CTD bases (without any interlayer) as a way of reflective crack control. Therefore, the focus of this study is to evaluate both these techniques by using the available time-series distress data (roughness, cracking, and rutting) in the pavement management system. With the help of this distress data, the performance of all different categories of projects was evaluated by two parameters: average service lives (SL) and benefit areas. Along with the ascertained cost, the SL and benefit areas were also used to determine benefit/cost (B/C) ratios for each category of projects. Subsequently, the cost-effectiveness of chip seal interlayer over CSD bases and CTD bases was assessed by the comparison of the B/C ratios. The performance and cost-effectiveness of few stone interlayer projects were also reported in this study. Finally, it was concluded that the chip seal interlayer is the least cost-effective option and CTD bases without any interlayer appeared to be the most cost-effective technique for reflective crack mitigation in Louisiana.

A Cost Effective Technique for Vacuum-assisted Closure Therapy With a Portable Suction System

2016 ◽  
Vol 31 (1) ◽  
pp. 53-56
Author(s):  
Akif Albayrak ◽  
Mehmet B. Balioğlu ◽  
Deniz Kargin ◽  
Umut Yavuz ◽  
Yunus Atici ◽  
...  
Keyword(s):  
Cost Effective ◽  
Vacuum Assisted Closure ◽  
Effective Technique ◽  
Suction System ◽  
Cost Effective Technique ◽  
Vacuum Assisted Closure Therapy

Within trial cost-effectiveness of a structured lifestyle intervention in adults with overweight/obesity and type 2 diabetes: Results from the Action for Health in Diabetes (Look AHEAD) Study

2020 ◽  
Author(s):  
Ping Zhang ◽  
Karen M. Atkinson ◽  
George Bray ◽  
Haiying Chen ◽  
Jeanne M. Clark ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Cost Effectiveness ◽  
Lifestyle Intervention ◽  
Health Utility Index ◽  
Health Benefit ◽  
Cost Effective ◽  
Health Utility ◽  
Health Care Expenditures ◽  
Quality Adjusted Life Year

<b>OBJECTIVE </b>To assess the cost-effectiveness (CE) of an intensive lifestyle intervention (ILI) compared to standard diabetes support and education (DSE) in adults with overweight/obesity and type 2 diabetes, as implemented in the Action for Health in Diabetes study. <p><b>RESEARCH DESIGN AND METHODS</b> Data were from 4,827 participants during the first 9 years of the study from 2001 to 2012. Information on Health Utility Index-2 and -3, SF-6D, and Feeling Thermometer [FT]), cost of delivering the interventions, and health expenditures were collected during the study. CE was measured by incremental cost-effectiveness ratios (ICERs) in costs per quality-adjusted life year (QALY). Future costs and QALYs were discounted at 3% annually. Costs were in 2012 US dollars. </p> <p><b>RESULTS </b><a>Over the </a>9 years studied, the mean cumulative intervention costs and mean cumulative health care expenditures were $11,275 and $64,453 per person for ILI and $887 and $68,174 for DSE. Thus, ILI cost $6,666 more per person than DSE. Additional QALYs gained by ILI were not statistically significant measured by the HUIs and were 0.17 and 0.16, respectively, measured by SF-6D and FT. The ICERs ranged from no health benefit with a higher cost based on HUIs, to $96,458/QALY and $43,169/QALY, respectively, based on SF-6D and FT. </p> <p><b>Conclusions </b>Whether<b> </b>ILI was cost-effective over the 9-year period is unclear because different health utility measures led to different conclusions. </p>

A Chemical Perspective to the Anti-Amyloid Action of Compounds and a Nanoparticle Based Assay for Screening Amyloid Inhibitors

2020 ◽  
Author(s):  
Nidhi Gour ◽  
Bharti Koshti
Keyword(s):  
Memory Loss ◽  
Cost Effective ◽  
Structural Motif ◽  
Rapid Screening ◽  
Stacking Interactions ◽  
Aromatic Rings ◽  
Amyloid Fibers ◽  
Aromatic Stacking ◽  
Cost Effective Technique ◽  
The Brain

Aggregation of amyloid beeta 1-42 (Aβ<sub>42</sub>) peptide causes the formation of clustered deposits knows as amyloid plaques in the brain which leads to neuronal dysfunction and memory loss and associated with many neurological disorders including Alzheimer’s and Parkinson’s. Aβ<sub>42</sub> has core structural motif with phenylalanine at the 19 and 20 positions. The diphenylalanine (FF) residue plays a crucial role in the formation of amyloid fibers and serves as model peptide for studying Aβ<sub>42 </sub>aggregation. FF self-assembles to well-ordered tubular morphology via aromatic pi-pi stackings. Our studies, suggest that the aromatic rings present in the anti-amyloidogenic compounds may interact with the pi-pi stacking interactions present in the FF. Even the compounds which do not have aromatic rings, like cyclodextrin and cucurbituril show anti-amyloid property due to the binding of aromatic ring inside the guest cavity. Hence, our studies also suggest that compounds which may have a functional moiety capable of interacting with the aromatic stacking interactions might be tested for their anti-amyloidogenic properties. Further, in this manuscript, we have proposed two novel nanoparticle based assays for the rapid screening of amyloid inhibitors. In the first assay, interaction between biotin-tagged FF peptide and the streptavidin labelled gold nanoparticles (s-AuNPs) were used. In another assay, thiol-Au interactions were used to develop an assay for detection of amyloid inhibitors. It is envisaged that the proposed analytical method will provide a simple, facile and cost effective technique for the screening of amyloid inhibitors and may be of immense practical implications to find the therapeutic remedies for the diseases associated with the protein aggregation.

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