Surgical wound management made easier and more cost-effective

Akagi, Ichiro; Furukawa, Kiyonori; Miyashita, Masao; Kiyama, Teruo; Matsuda, Akihisa; Nomura, Tsutomu; Makino, Hiroshi; Hagiwara, Nobutoshi; Takahashi, Ken; Uchida, Eiji

doi:10.3892/ol.2012.687

Cited by 10 publications

(24 citation statements)

References 8 publications

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“…The five included studies focused on selection of postoperative wound dressings, and compared either negative pressure (vacuum), gauze or film dressings, or wound management protocols using selected dressings. Of the five economic studies, two were conducted in Australia, and one each in Japan, Spain and England ( Table ). These economic evaluations were published between 2000 and 2016, with the majority being published in the past 4 years.…”

Section: Resultsmentioning

confidence: 99%

“…These economic evaluations were published between 2000 and 2016, with the majority being published in the past 4 years. Two studies were cost‐effectiveness analyses, two were cost–utility analyses and one was a cost–benefit analysis. Detailed descriptions of the included studies are provided in Table .…”

Section: Resultsmentioning

confidence: 99%

“…Of the five included studies, two were from the perspective of the healthcare provider whereas other three did not explicitly state the study perspective. The costs of interventions were reported in different ways, such as mean cost per patient or patient episode, cost of managing a hypothetical cohort of 1000 surgical patients and cost of each arm of care.…”

Section: Resultsmentioning

confidence: 99%

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Economic case for intraoperative interventions to prevent surgical-site infection

Gillespie

Chaboyer

Erichsen-Andersson

et al. 2017

British Journal of Surgery

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Background: Surgical-site infection (SSI) occurs in 1-10 per cent of all patients undergoing surgery; rates can be higher depending on the type of surgery. The aim of this review was to establish whether (or not) surgical hand asepsis, intraoperative skin antisepsis and selected surgical dressings are cost-effective in SSI prevention, and to examine the quality of reporting. Methods:The authors searched MEDLINE via Ovid, CINAHL via EBSCO, Cochrane Central and Scopus databases systematically from 1990 to 2016. Included were RCTs and quasi-experimental studies published in English, evaluating the economic impact of interventions to prevent SSI relative to surgical hand and skin antisepsis, and wound dressings. Characteristics and results of included studies were extracted using a standard data collection tool. Study and reporting quality were assessed using SIGN and CHEERS checklists.Results: Across the three areas of SSI prevention, the combined searches identified 1214 articles. Of these, five health economic studies evaluating the cost-effectiveness of selected surgical dressings were eligible. Study authors concluded that the interventions being assessed were cost-effective, or were potentially cost-saving. Still, there is high uncertainty around the decision to adopt these dressings/devices in practice. The studies' reporting quality was reasonable; three reported at least 15 of the 24 CHEERS items appropriately. Assessment of methodological quality found that two studies were considered to be of high quality. Conclusion:With few economic studies undertaken in this area, the cost-effectiveness of these strategies is unclear. Incorporating economic evaluations alongside RCTs will help towards evidence-informed decisions.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Economic case for intraoperative interventions to prevent surgical-site infection

Gillespie

Chaboyer

Erichsen-Andersson

et al. 2017

British Journal of Surgery

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“…Chronic wounds are those that have not progressed through the ordered process of healing to yield a functional result [1]. Recently, the terminology for chronic wounds has changed.…”

Section: Introductionmentioning

confidence: 99%

“…One of the following characteristics is necessary for a wound to be classified as being complex: i) has not healed in 3 months, ii) infection is present, iii) compromised viability of superficial tissues, necrosis, or circulation impairment, and iv) association with systemic pathologies, impairing normal healing [2]. The main types of complex wounds include diabetic leg/foot ulcers, pressure ulcers [3], chronic venous ulcers, infected wounds [1,4,5], and those related to vasculitis and immunosuppressive therapy that have not healed using simple care [2]. …”

Section: Introductionmentioning

confidence: 99%

Seeking effective interventions to treat complex wounds: an overview of systematic reviews

Tricco

Antony

Vafaei

et al. 2015

BMC Med

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BackgroundNumerous, often multi-faceted regimens are available for treating complex wounds, yet the evidence of these interventions is recondite across the literature. We aimed to identify effective interventions to treat complex wounds through an overview of systematic reviews.MethodsMEDLINE (OVID interface, 1946 until October 26, 2012), EMBASE (OVID interface, 1947 until October 26, 2012), and the Cochrane Database of Systematic Reviews (Issue 10 of 12, 2012) were searched on October 26, 2012. Systematic reviews that examined adults receiving care for their complex wounds were included. Two reviewers independently screened the literature, abstracted data, and assessed study quality using the Assessment of Multiple Systematic Reviews (AMSTAR) tool.ResultsOverall, 99 systematic reviews were included after screening 6,200 titles and abstracts and 422 full-texts; 54 were systematic reviews with a meta-analysis (including data on over 54,000 patients) and 45 were systematic reviews without a meta-analysis. Overall, 44% of included reviews were rated as being of high quality (AMSTAR score ≥8). Based on data from systematic reviews including a meta-analysis with an AMSTAR score ≥8, promising interventions for complex wounds were identified. These included bandages or stockings (multi-layer, high compression) and wound cleansing for venous leg ulcers; four-layer bandages for mixed arterial/venous leg ulcers; biologics, ultrasound, and hydrogel dressings for diabetic leg/foot ulcers; hydrocolloid dressings, electrotherapy, air-fluidized beds, and alternate foam mattresses for pressure ulcers; and silver dressings and ultrasound for unspecified mixed complex wounds. For surgical wound infections, topical negative pressure and vacuum-assisted closure were promising interventions, but this was based on evidence from moderate to low quality systematic reviews.ConclusionsNumerous interventions can be utilized for patients with varying types of complex wounds, yet few treatments were consistently effective across all outcomes throughout the literature. Clinicians and patients can use our results to tailor effective treatment according to type of complex wound. Network meta-analysis will be of benefit to decision-makers, as it will permit multiple treatment comparisons and ranking of the effectiveness of all interventions.Please see related article: http://dx.doi.org/10.1186/s12916-015-0326-3Electronic supplementary materialThe online version of this article (doi:10.1186/s12916-015-0288-5) contains supplementary material, which is available to authorized users.

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Comparison of Sterile vs Nonsterile Gloves in Cutaneous Surgery and Common Outpatient Dental Procedures

Brewer

Gonzalez²,

Baum

et al. 2016

JAMA Dermatol

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Surgical wound management made easier and more cost-effective

Cited by 10 publications

References 8 publications

Economic case for intraoperative interventions to prevent surgical-site infection

Economic case for intraoperative interventions to prevent surgical-site infection

Seeking effective interventions to treat complex wounds: an overview of systematic reviews

Comparison of Sterile vs Nonsterile Gloves in Cutaneous Surgery and Common Outpatient Dental Procedures

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