The humanistic and economic burden of chronic wounds: A systematic review

Abstract

Chronic wounds are a health problem that have devastating consequences for patients and contribute major costs to healthcare systems and societies. To understand the magnitude of this health issue, a systematic review was undertaken. Searches were conducted in MEDLINE, EMBASE, EBM Reviews and Cochrane library, CINAHL, EBSCO, PsycINFO, and Global Health databases for articles published between 2000 and 2015. Included publications had to target adults (≥18 years of age), state wound chronicity (≥3 weeks) and/or label the wounds as chronic, complex, hard‐to‐heal, or having led to an amputation. The review excluded studies that did not present data on generic health‐related quality of life and/or cost data, case studies, randomized controlled trials, economic modeling studies, abstracts, and editorials. Extracted data were summarized into a narrative synthesis, and for a few articles using the same health‐related quality of life instrument, average estimates with 95% confidence intervals were calculated. Thirty articles met the inclusion criteria. Findings revealed that health‐related quality of life was lowest for physical pathologies, and based on average estimates were scores most inferior in the domain physical role for both patients with chronic wounds and for those with wound‐related amputations. The cost burden was mainly attributed to amputations for patients also comorbid with diabetes, where the cost for hospitalization ranged from US$12,851 to US$16,267 (median) for this patient group. Patients with chronic wounds have poor health‐related quality of life in general and wound‐related costs are substantial. Development and implementation of wound management strategies that focus on increasing health‐related quality of life and effectively reduce costs for this patient group are urgently needed.

Validation of the Dutch translation of the Cardiff wound impact schedule for evaluation of the health‐related quality of life of patients with chronic wounds

“…The hospital admittance costs for a diabetes‐related amputation for one patient ranged from US $12 851 to US $16 267 (median). Next to this direct economic burden, there is also an indirect cost to society: chronic wounds can, for example, lead to loss of productivity, inability to perform certain work tasks, and may even lead to early retirement 4 …”

Antibiotic‐Free Antibacterial Strategies Enabled by Nanomaterials: Progress and Perspectives

“…Treatment for wound infection is of great clinical significance and urgency. The annual cost of wound care in the United States has been reported to be $25 billion, while in the UK, the cost in 2012 was estimated to be £4.5 billion, suggesting an intense need for advances in research on wound care . As a result, recent efforts have been devoted to the development of wound dressings for wound disinfection, including conventional dressings, artificial dressings, and biomaterial dressings.…”

First-Line Interactive Wound Dressing Update: A Comprehensive Review of the Evidence

“…Chronic wounds are associated with a significant health-related quality of life burden and carry high economic costs to society in high income countries (Graves and Zheng, 2014;Guest et al, 2017;Cheng et al, 2018;Olsson et al, 2019). Prevalence is projected to increase due to an aging population and increasing incidence of obesity, diabetes, and cardiovascular diseases .…”

“…Optimal wound care requires clinicians' understanding of wound etiology, wound chronicity, the mechanism and biology of wound healing, and factors that affect wound healing (Ather et al, 2019). The first consideration must be given to accurate diagnosis of wound etiology and appropriate treatment, followed by appropriate dressing selection (Ather et al, 2019;Olsson et al, 2019). Knowledge of dressing products and their properties and dressing selection skills are two major components in clinical decision making and holistic wound care (Dowsett and von Hallern, 2017).…”