Human skin wounds: A major and snowballing threat to public health and the economy

Abstract

In the United States, chronic wounds affect around 6.5 million patients. It is claimed that an excess of US$25 billion is spent annually on treatment of chronic wounds and the burden is growing rapidly due to increasing health care costs, an aging population and a sharp rise in the incidence of diabetes and obesity worldwide. The annual wound care products market is projected to reach $15.3 billion by 2010. Chronic wounds are rarely seen in individuals who are otherwise healthy. In fact, chronic wound patients frequently suffer from “highly branded” diseases such as diabetes and obesity. This seems to have overshadowed the significance of wounds per se as a major health problem. For example, NIH’s Research Portfolio Online Reporting Tool (RePORT; http://report.nih.gov/), directed at providing access to estimates of funding for various disease conditions do list several rare diseases but does not list wounds. According to the latest data from the National Center for Health Statistics, 40 million inpatient surgical procedures were performed in the United States in 2000, followed closely by 31.5 million outpatient surgeries. The need for post-surgical wound care is sharply on the rise. Emergency wound care in an acute setting has major significance not only in a war setting but also in homeland preparedness against natural disasters as well as against terrorism attacks. An additional burden of wound healing is the problem of skin scarring, a $12 billion annual market. Current research advances in the field have led to solutions that have been effective in improving patient care. The immense economic and social impact of wounds in our society calls for allocation of a higher level of attention and resources to understand biological mechanisms underlying cutaneous wound complications. Investment in the detailed scrutiny of wounds presented clinically as well as in pre-clinical models seems prudent.

Critical Reviews: How we treat sickle cell patients with leg ulcers

“…A recent survey of North American hematologists specializing in SCD, estimated that 1% SCD patients have active ulcers [10], while in the Bethesda Cohort of more than 500 SCD patients, 22% of HbSS and 9% of HbSC patients reported "history of ulcer" [5]. Regardless, leg ulcers occur ten times more frequently in SCD than the general population and begin at a younger age [11]. There is a wide geographic variation, with an involvement of about 70% of patients with HBSS by the 30th year of life previously reported in Jamaica [12], and recent estimates decreased to a prevalence of 29.5%, and an incidence of 16.5% [13].…”

“…Skin ulcers in the general population rarely occur in individuals that are otherwise healthy, and it is plausible that SCD itself is strong risk factor for skin ulceration. As such, SCD ulcers may not be fundamentally different from other chronic ulcers, but a mix of venous and arterial ulceration components [11].…”

Dehydrated human amnion/chorion membrane regulates stem cell activity in vitro

“…Chronic wound management, including diabetic foot ulcers and venous ulcers, remains a significant clinical challenge, affecting approximately 6.5 million patients in the United States with cost of care exceeding $25 billion annually 1. Expediting wound closure and preventing them from progressing to the point of chronicity is the aim of the clinician treating the patient.…”

Harnessing the Electric Spark of Life to Cure Skin Wounds

“…Annually, about 1% of the population incurs skin wounds that need medical attention. 1 Surgical wound infection affects 30-40 patients per 1,000 operations, and its effects can be life threatening. Pressure ulcers have a major negative effect on patient function and quality of life and strikingly; around one in five in-patients in European hospitals has a pressure ulcer.…”