Clinical outcomes and cost-effectiveness of three alternative compression systems used in the management of venous leg ulcers

Abstract

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The health economic burden that acute and chronic wounds impose on an average clinical commissioning group/health board in the UK

“…Our study has also highlighted the lack of senior involvement (both tissue viability teams and other specialist health-care professionals) in clinical wound care. Additionally, there appears to be no correlation between wound complexity, wound duration and senior involvement, [23][24][25] although chronic wounds use substantially more resources than acute wounds. The lack of senior engagement in wound care may have had a detrimental impact on outcomes, and thereby contributed to the increasing prevalence and cost of wound management.…”

“…2 In addition to our burden of wound study, 1,2 we have previously highlighted inconsistencies in wound care, staff involvement and dressing choice, with an apparent lack of a patient-specific treatment plan in many instances. [23][24][25] Wound care products account for only 12-15% of the cost of wound management with non-healing being a major driver for increased product costs. 2 Additionally, while there is a range of nursing staff (practice/community/specialist) involved in the delivery of wound care, there appears to be an increasing involvement of practice nurses.…”

“…The changing role of tissue viability nurses in line with the ongoing target requirements related to pressure ulcer prevention 26 may partly explain their reduced involvement in front-line wound care. 1,2 Based on several studies assessing wound care in clinical practice, [23][24][25] it has become difficult to define who is responsible for the care of an individual patient's wound and the management of any associated comorbidities. Moreover, the role of the GP and other community-based medical staff is inconsistent.…”

“…Moreover, the role of the GP and other community-based medical staff is inconsistent. 1,2,[23][24][25] Communication between practitioners appears to be poor, with no clear role allocation. Accordingly, the role of health-care professionals including practice nurses, community nurses, tissue viability nurses, podiatrists, GPs and other medical professionals needs to be clearly defined within the patient care pathway.…”

What is the existing evidence supporting the efficacy of compression bandage systems containing both elastic and inelastic components (mixed‐component systems)? A systematic review

“…Had the author been able to access a research team to support larger study, a more comprehensive picture of the efficacy of MCSs might have been obtained. Following completion of the review, new evidence comparing MCSA to MCSB also emerged; a retrospective analysis of patients' records in the UK found both systems to be associated with positive outcomes including cost-effectiveness, ulcer healing and QoL (Guest et al 2015). The design of the study would have potentially contributed towards answering the research question as it would have strengthened the variation in methodologies included in the review, whilst additional data on cost-effectiveness of MCSs would have been useful as it was not an outcome in any of the studies included in this review.…”