scholarly journals Surgical wound management made easier and more cost-effective

2012 ◽  
Vol 4 (1) ◽  
pp. 97-100 ◽  
Author(s):  
ICHIRO AKAGI ◽  
KIYONORI FURUKAWA ◽  
MASAO MIYASHITA ◽  
TERUO KIYAMA ◽  
AKIHISA MATSUDA ◽  
...  
Keyword(s):  
Cost Effective ◽  
Wound Management ◽  
Surgical Wound

scholarly journals Cost-effectiveness of negative-pressure wound therapy in adults with severe open fractures of the lower limb: evidence from the WOLLF randomized controlled trial

2019 ◽  
Vol 101-B (11) ◽  
pp. 1392-1401 ◽  
Author(s):  
S. Petrou ◽  
B. Parker ◽  
J. Masters ◽  
J. Achten ◽  
J. Bruce ◽  
...  
Keyword(s):  
Economic Evaluation ◽  
Cost Effectiveness ◽  
Lower Limb ◽  
Negative Pressure Wound Therapy ◽  
Cost Effective ◽  
Open Fractures ◽  
Wound Management ◽  
Wound Therapy ◽  
Subgroup Analyses ◽  
The Cost

Aims The aim of this study was to estimate the cost-effectiveness of negative-pressure wound therapy (NPWT) in comparison with standard wound management after initial surgical wound debridement in adults with severe open fractures of the lower limb. Patients and Methods An economic evaluation was conducted from the perspective of the United Kingdom NHS and Personal Social Services, based on evidence from the 460 participants in the Wound Management of Open Lower Limb Fractures (WOLLF) trial. Economic outcomes were collected prospectively over the 12-month follow-up period using trial case report forms and participant-completed questionnaires. Bivariate regression of costs (given in £, 2014 to 2015 prices) and quality-adjusted life-years (QALYs), with multiple imputation of missing data, was conducted to estimate the incremental cost per QALY gained associated with NPWT dressings. Sensitivity and subgroup analyses were undertaken to assess the impacts of uncertainty and heterogeneity, respectively, surrounding aspects of the economic evaluation. Results The base case analysis produced an incremental cost-effectiveness ratio of £267 910 per QALY gained, reflecting higher costs on average (£678; 95% confidence interval (CI) -£1082 to £2438) and only marginally higher QALYS (0.002; 95% CI -0.054 to 0.059) in the NPWT group. The probability that NPWT is cost-effective in this patient population did not exceed 27% regardless of the value of the cost-effectiveness threshold. This result remained robust to several sensitivity and subgroup analyses. Conclusion This trial-based economic evaluation suggests that NPWT is unlikely to be a cost-effective strategy for improving outcomes in adult patients with severe open fractures of the lower limb. Cite this article: Bone Joint J 2019;101-B:1392–1401.

Surgical wound management

Injury ◽  
2007 ◽  
Vol 38 (5) ◽  
pp. S1-S2
Author(s):  
Peter Giannoudis
Keyword(s):  
Wound Management ◽  
Surgical Wound

scholarly journals Telemedicine for wound management

2012 ◽  
Vol 45 (02) ◽  
pp. 412-417 ◽  
Author(s):  
Ravi K. Chittoria
Keyword(s):  
Health Care ◽  
Chronic Wounds ◽  
Wound Care ◽  
Cost Effective ◽  
Skin Lesions ◽  
Wound Management ◽  
Care Practice ◽  
Telemedicine Technology ◽  
Store And Forward ◽  
Financial Burdens

ABSTRACTThe escalating physiological, psychological, social and financial burdens of wounds and wound care on patients, families and society demand the immediate attention of the health care sector. Many forces are affecting the changes in health care provision for patients with chronic wounds, including managed care, the limited number of wound care therapists, an increasingly ageing and disabled population, regulatory and malpractice issues, and compromised care. The physician is also faced with a number of difficult issues when caring for chronic wound patients because their conditions are time consuming and high risk, represent an unprofitable part of care practice and raise issues of liability. Telemedicine enhances communication with the surgical wound care specialist. Digital image for skin lesions is a safe, accurate and cost-effective referral pathway. The two basic modes of telemedicine applications, store and forward (asynchronous transfer) and real-time transmission (synchronous transfer, e.g. video conference), are utilized in the wound care setting. Telemedicine technology in the hands of an experienced physician can streamline management of a problem wound. Although there is always an element of anxiety related to technical change, the evolution of wound care telemedicine technology has demonstrated a predictable maturation process.

Surgical wound management: the role of dressings

2001 ◽  
Vol 15 (44) ◽  
pp. 59-69 ◽  
Author(s):  
Lynne Watret ◽  
Richard White
Keyword(s):  
Wound Management ◽  
Surgical Wound

scholarly journals Study of hydrocellular functional material as microbicidal wound dressing for diabetic wound healing

2021 ◽  
Vol 19 ◽  
pp. 228080002110549
Author(s):  
Michael Rodrigues ◽  
Thilagavati Govindharajan
Keyword(s):  
Wound Healing ◽  
Wound Dressing ◽  
Wound Care ◽  
Cost Effective ◽  
Wound Dressings ◽  
Wound Management ◽  
Histopathological Analysis ◽  
Diabetic Wound ◽  
Functional Material ◽  
Diabetic Wound Healing

A hydrocellular functional material as a wound dressing is developed and it is found to be superior in its efficacy as compared to some of the comparator controls in diabetic wound healing studies. A study on wound contraction and Histopathological analysis is done in rats. The efficacy of the dressing is comparable to the established wound dressings like Carboxymethyl cellulose alginate dressings and autolytic enzyme based hydrogel. It is found to be superior to Polyhexamethylene biguanide dressing used as reference controls in this study. The reason for good wound healing performance of the dressing can be attributed to a combined property of effective exudates management and broad spectrum antimicrobial effect. The concept of functional hydro cellular material has shown good results due to the excellent balance of exudates pickup and drying it out. This ensures moist wound healing conditions on the wound. Because of its porous nature it allows good air flow and gaseous exchange in the structure. The cationic sites created on the surface of the dressing ensure a good antimicrobial action on the exudates in the dressing. It reduces the infection load on the wound. The nonleaching property of the dressing also helps in preventing the generation of more resistant and mutant strains of the microbes. The developed dressing can be used as a relatively durable long lasting dressing for wound management in diabetic wounds. The need of repetitive wound dressing changes can be brought down with this concept of dressing. It is not only cost effective in terms of its material cost but also is a cost effective solution when entire wound management cost is considered. Such novel wound dressing material can change the quality of life of diabetic wound patients especially in developing world, where access to functional advanced wound care dressings is limited.

scholarly journals Use of Virtual Reality as a Distraction Technique to Limit Opiate Use in Traumatic and Surgical Wound Dressing Management

2020 ◽  
pp. 1-3
Author(s):  
Albert Chi ◽  
Albert Chi ◽  
Julius Jockusch ◽  
Michael Long ◽  
Peter Lund ◽  
...  
Keyword(s):  
Virtual Reality ◽  
Wound Management ◽  
Source Control ◽  
Hand Tracking ◽  
Surgical Wound ◽  
Prosthetic Devices ◽  
Opiate Use ◽  
A Prospective Study ◽  
Dressing Change ◽  
Operative Wound

Background: Chronic opiate use in traumatic and surgical wound management has become an increasingly controversial topic nationally. Here we present a case of a large surgical wound previously managed with operative dressing changes with significant opiate use for pain control with the use of virtual reality at the time of dressing changes to decrease opiate use as well as operative need; and therefore, overall cost. Case Presentation: The patient is a 57-year-old female with morbid obesity and poorly controlled diabetes mellitus who presented with a necrotizing soft tissue infection of the left thigh. She was admitted to the intensive care unit, initiated on broad spectrum antibiotics, and taken to the operating room for excisional debridement. After stabilization and source control, the patient continued to require operative incisional wound vac changes every other day despite maximal multimodal pain therapy. After discussion with the patient regarding her continued ongoing operative wound vac changes and her desire to progress care, the team attempted a bedside dressing change utilizing the Facebook Oculus Quest Virtual Reality device application “Nature Treks VR”. The patient endorsed reduced pain scores during the dressing change and endorsed emersion into the virtual world throughout the dressing change. Conclusion: To the best of our knowledge this is the first reported incidence of using a virtual reality platform to reduce opiate use, operative need, progression of care, and overall cost in a patient with a large, debilitating operative wound outside of the burn population. Advances in virtual reality hardware including tether less systems like Oculus Quest, non-controller hand tracking and headset sanitation devices have reduced barriers to introducing virtual reality therapy into the clinic and ICU. A prospective study is needed to validate the use of virtual reality as a distraction therapy at the time of dressing changes. Future use of virtual reality may involve reducing ICU delirium, targeted pain management, post trauma recovery exercises and enhanced rehabilitation of amputees with prosthetic devices.

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