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Leaper D.,University of Cardiff | Nazir J.,Smith and Nephew Medical Ltd | Roberts C.,Smith and Nephew Medical Ltd | Searle R.,Smith and Nephew Healthcare Ltd.
Journal of Medical Economics | Year: 2010

Objective: In patients at risk of surgical site infection (SSI), there is evidence that an antimicrobial barrier dressing (Acticoat*) applied immediately post-procedure is effective in reducing the incidence of infection. The objective of this study was to assess when it is appropriate to use an antimicrobial barrier dressing rather than a post-operative film dressing, by evaluating the net cost and budget impact of the two strategies. Methods: An economic model was developed, which estimates expected expenditure on dressings and the expected costs of surgical site infection during the initial inpatient episode, based on published literature on the pre-discharge costs of surgical infection and the efficacy of an antimicrobial barrier dressing in preventing SSI. Results: At an SSI risk of 10, an antimicrobial barrier dressing strategy is cost neutral if the incidence of infection is reduced by at least 9 compared with a post-operative film dressing. At 35 efficacy, expenditure on dressings would be higher by £30,760 per 1000 patients, and the cost of treating infection would be lower by £111,650, resulting in a net cost saving of £80,890. The break-even infection risk for cost neutrality is 2.6. Limitations: Although this cost analysis is based on published data, there are limitations in methodology: the model is dependent on and subject to the limitations of the data used to populate it. Further studies would be useful to increase the robustness of the conclusions, particularly in a broader range of surgical specialities. Conclusions: A strategy involving the use of an antimicrobial barrier dressing in patients at moderate (510) or high (>10) risk of infection appears reasonable and cost saving in light of the available clinical evidence. © 2010 Informa UK Ltd All rights reserved: reproduction in whole or part not permitted.


Dowsett C.,Nurse Consultant Tissue Viability | Davis L.,Tissue Viability Lead Nurse | Henderson V.,Clinical Lead Tissue Viability | Searle R.,Smith and Nephew Healthcare Ltd.
International Wound Journal | Year: 2012

The human and economic costs of wounds are of major concern within today's National Health Service. Advances in wound care technology have been shown to be beneficial both in healing and in relation to patient quality of life. Negative pressure has often been associated with high-cost care and restricted to use in the secondary care setting. There is growing use of negative pressure within the community, and this has the potential to benefit the patient and the service by providing quality care in the patient's home setting. Three community sites were chosen to monitor their use of negative pressure wound therapy (NPWT) over a period of 2 years, and this paper presents some of the key findings of this work. The data generated has been used to help target resources and prevent misuse of therapy. Cost per patient episode has been calculated, and this can be compared to similar costs in secondary care, showing significant savings if patients are discharged earlier from secondary care. There is also an increased demand for more patients with complex wounds to be cared for in the community, and in the future, it is likely that community initiated NPWT may become more common. Early analysis of the data showed that the average cost of dressing complex wounds would be significantly less than using traditional dressings, where increased nursing visits could increase costs. There is a compelling argument for more negative pressure to be used and initiated in the community, based not only on improved quality of life for patients but also on the economic benefits of the therapy. © 2012 The Authors. International Wound Journal © 2012 Blackwell Publishing Ltd and Medicalhelplines.com Inc.


Simon D.,5 Boroughs Partnership NHS Foundation Trust | Biel A.,Smith and Nephew Healthcare Ltd.
Wounds UK | Year: 2014

Effective wound management comprises the informed selection and application of products matched to the patient being treated, and to a clearly defined and achievable clinical objective shared by both the clinician and the patient. The authors detail an in-practice case series appraisal process used to examine the performance of ALLEVYN Life (Smith & Nephew Healthcare Ltd) in order to determine its suitability for a formulary listing.


Roberts N.,Northern General Hospital | Sorrell J.,Northern General Hospital | Bielby A.,Smith and Nephew Healthcare Ltd. | Searle R.,Smith and Nephew Healthcare Ltd.
Wounds UK | Year: 2011

Aims: The National Institute of Health and Clinical Excellence (NICE) recommend that at the end of an operation 'surgical incisions anticipated to heal by primary intention should be covered by a film membrane, with or without a central absorbent pad'. The objectives of this project were to measure the usage and acceptability of a postoperative dressing, and evaluate the use of resources and incidence of surgical site infection (SSI). Methods: The approach comprised a survey of current practice (non-woven dressings) followed by a further survey with a vapour-permeable film dressing after a programme of education and training in the use of the new product. Results: The incidence of SSI was 6.4% (5/78) using the non-woven dressing, and 4.8% (5/104) using the vapour-permeable barrier dressing. Conclusions: Using a cost model with conservative assumptions, a cost-saving of £13 per patient was observed after adoption of the vapour-permeable film dressing. Declaration of interest: Richard Searle and Alistair Bielby are employees of Smith & Nephew. This project was supported by an unrestricted grant from Smith & Nephew.


Stephen-Haynes J.,City University London | Bielby A.,Smith and Nephew Healthcare Ltd. | Searle R.,Smith and Nephew Healthcare Ltd.
Wounds UK | Year: 2011

This article proposes a systematic, measured and disciplined approach to wound care in order to maximise efficiency and reconcile the apparently conflicting issues of dwindling resources and increasing demand for quality care. This integrated approach to wound care would use advanced wound care techniques and products in accordance with best practice guidelines and support appropriate use through a programme of education and training. The effectiveness of this approach in changing practice would be underpinned via an ongoing process of monitoring and evaluation.

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