Abstract:Demographic and epidemiological data suggest that health-care demand will increase considerably in the future as a result of an ageing population and a rise in the prevalence of chronic diseases such as diabetes. This phenomenon has come to be referred to as the 'health care time bomb' in the popular press and political discourse. The authors seek to look beyond the headlines and political rhetoric to clarify the extent to which they reflect the likely future reality with a specific focus on wound management. … Show more
“…This trend is clearly unsustainable, and as a result, it is vital that health care providers seek more efficient ways of managing a resource‐intensive casemix with increasingly complex needs, such as patients with a wound. Wound management is estimated to account for over 50% of community nurse time in European studies, with patients often having three or more home health visits per week .The demands on nurse time are expected to increase further because of earlier hospital discharge, ageing populations and increasing rates of morbidities associated with wounds .For example, the International Diabetes Foundation estimates that worldwide diabetes prevalence will continue to increase to 9·9% by 2030 .Diabetic patients have up to a 25% lifetime risk of developing a foot ulcer .The increasing demands on nurse time will become unsustainable if the present trend continues, and health systems need to identify more efficient ways of managing the increased workload.Question: Are there any estimates of how much demand for wound management services will increase?Answer: Yes, in some countries. For example, in 2010, it was estimated that the cost of wound management in municipalities in Denmark was DKK 735 m (18 000 wounds per year requiring over 3 m dressing changes).…”
Section: The Impact Of Wounds On the Health System – A Growing Challengementioning
confidence: 99%
“…The demands on nurse time are expected to increase further because of earlier hospital discharge, ageing populations and increasing rates of morbidities associated with wounds .…”
Section: The Impact Of Wounds On the Health System – A Growing Challengementioning
confidence: 99%
“…Wound management is estimated to account for over 50% of community nurse time in European studies, with patients often having three or more home health visits per week (7,9,10,21). The demands on nurse time are expected to increase further because of earlier hospital discharge, ageing populations and increasing rates of morbidities associated with wounds (22). For example, the International Diabetes Foundation estimates that worldwide diabetes prevalence will continue to increase to 9⋅9% by 2030 (25).…”
Section: Demand For Wound Management Servicesmentioning
Treatment of wounds of different aetiologies constitutes a major part of the total health care budget. It is estimated that 1⋅5-2 million people in Europe suffer from acute or chronic wounds. These wounds are managed both in hospitals and in community care. The patients suffering from these wounds report physical, mental and social consequences of their wounds and the care of them. It is often believed that the use of wound dressings per se is the major cost driver in wound management, whereas in fact, nursing time and hospital costs are together responsible for around 80-85% of the total cost. Healing time, frequency of dressing change and complications are three important cost drivers. However, with the use of modern, advanced technology for more rapid wound healing, all these cost drivers can be substantially reduced. A basic understanding of the terminology and principles of Health Economics in relation to wound management might therefore be of interest.
“…This trend is clearly unsustainable, and as a result, it is vital that health care providers seek more efficient ways of managing a resource‐intensive casemix with increasingly complex needs, such as patients with a wound. Wound management is estimated to account for over 50% of community nurse time in European studies, with patients often having three or more home health visits per week .The demands on nurse time are expected to increase further because of earlier hospital discharge, ageing populations and increasing rates of morbidities associated with wounds .For example, the International Diabetes Foundation estimates that worldwide diabetes prevalence will continue to increase to 9·9% by 2030 .Diabetic patients have up to a 25% lifetime risk of developing a foot ulcer .The increasing demands on nurse time will become unsustainable if the present trend continues, and health systems need to identify more efficient ways of managing the increased workload.Question: Are there any estimates of how much demand for wound management services will increase?Answer: Yes, in some countries. For example, in 2010, it was estimated that the cost of wound management in municipalities in Denmark was DKK 735 m (18 000 wounds per year requiring over 3 m dressing changes).…”
Section: The Impact Of Wounds On the Health System – A Growing Challengementioning
confidence: 99%
“…The demands on nurse time are expected to increase further because of earlier hospital discharge, ageing populations and increasing rates of morbidities associated with wounds .…”
Section: The Impact Of Wounds On the Health System – A Growing Challengementioning
confidence: 99%
“…Wound management is estimated to account for over 50% of community nurse time in European studies, with patients often having three or more home health visits per week (7,9,10,21). The demands on nurse time are expected to increase further because of earlier hospital discharge, ageing populations and increasing rates of morbidities associated with wounds (22). For example, the International Diabetes Foundation estimates that worldwide diabetes prevalence will continue to increase to 9⋅9% by 2030 (25).…”
Section: Demand For Wound Management Servicesmentioning
Treatment of wounds of different aetiologies constitutes a major part of the total health care budget. It is estimated that 1⋅5-2 million people in Europe suffer from acute or chronic wounds. These wounds are managed both in hospitals and in community care. The patients suffering from these wounds report physical, mental and social consequences of their wounds and the care of them. It is often believed that the use of wound dressings per se is the major cost driver in wound management, whereas in fact, nursing time and hospital costs are together responsible for around 80-85% of the total cost. Healing time, frequency of dressing change and complications are three important cost drivers. However, with the use of modern, advanced technology for more rapid wound healing, all these cost drivers can be substantially reduced. A basic understanding of the terminology and principles of Health Economics in relation to wound management might therefore be of interest.
“…This may not have been an issue before, but now the exponential increase in acute, chronic and post-surgical wound care costs predicted in most of the health care systems of countries, including the United Kingdom and United States have risen extensively. [1,11,15,20,21] Suitable care and management of wounds can prevent the progression into chronic wounds. [15] It has been observed that it is not always the most expensive wound care products that advance wound healing, but rather emphasis is placed on moist topical wound care (alginates, antimicrobials, etc).…”
This study aimed to determine the antimicrobial activity of 247 essential oil combinations against the reference strains of wound pathogens. Essential oil combinations were investigated for antimicrobial activity against five pathogens. The minimum inhibitory concentration (MIC) assay was used and the fractional inhibitory concentration index (ΣFIC) calculated to determine interactions between selected oils. Twenty‐six combinations displayed broad‐spectrum antimicrobial activity against all five reference strains and several displayed synergy against more than one pathogen. The combination of Santalum austrocaledonicum (sandalwood) with Commiphora myrrha (myrrh) displayed noteworthy antimicrobial activity against all five reference strains and synergy against four (MIC values 0.03–1.00 mg/ml and ΣFIC values 0.19–1.00 mg/ml) pathogens. No antagonism was observed. Santalum spp. and Vetiveria zizanioides essential oils contributed the most to antimicrobial activity in combination. Essential oil combinations are presented as a viable option in wound therapy.
“…Chronic wounds, which include diabetic, venous, and pressure ulcers, are a significant global problem, causing patient morbidity and a substantial financial burden on health services worldwide. The incidence of chronic wounds is currently rising because those populations most susceptible, the elderly and diabetic, are rapidly expanding . This in turn puts increasing financial strain on health services.…”
Chronic wounds often exist in a heightened state of inflammation whereby excessive inflammatory cells release high levels of proteases and reactive oxygen species (ROS). While low levels of ROS play a fundamental role in the regulation of normal wound healing, their levels need to be tightly regulated to prevent a hostile wound environment resulting from excessive levels of ROS. Infection amplifies the inflammatory response, augmenting levels of ROS which creates additional tissue damage that supports microbial growth. Antimicrobial dressings are used to combat infection; however, the effects of these dressing on the wound environment and healing independent of infection are rarely assessed. Cytotoxic or adverse effects on healing may exacerbate the hostile wound environment and prolong healing. Here we assessed the effect on healing independent of infection of silver oxysalts which produce higher oxidative states of silver (Ag /Ag ). Silver oxysalts had no adverse effect on fibroblast scratch wound closure whilst significantly promoting closure of keratinocyte scratch wounds (34% increase compared with control). Furthermore, dressings containing silver oxysalts accelerated healing of full-thickness incisional wounds in wild-type mice, reducing wound area, promoting reepithelialization, and dampening inflammation. We explored the mechanisms by which silver oxysalts promote healing and found that unlike other silver dressings tested, silver oxysalt dressings catalyze the breakdown of hydrogen peroxide to water and oxygen. In addition, we found that silver oxysalts directly released oxygen when exposed to water. Collectively, these data provide the first indication that silver oxysalts promote healing independent of infection and may regulate oxidative stress within a wound through catalysis of hydrogen peroxide.
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