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Hull, United Kingdom

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Stephen-Haynes J.,City University London | Stephen-Haynes J.,Worcestershire Health Care NHS Trust | 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.


Grant
Agency: GTR | Branch: EPSRC | Program: | Phase: Research Grant | Award Amount: 844.47K | Year: 2016

Chronic wounds are those that fail to heal in an orderly and timely (typically three months) manner. Examples of chronic wounds include diabetic foot ulcers, pressure ulcers and venous leg ulcers. The incidence of chronic wounds is increasing as a result of lifestyle changes and the ageing population. For example, ~552 million people worldwide are estimated to have diabetes mellitus in 2030. Up to an estimated 25% of these patients will develop diabetic foot ulcers in their lifetime; half of these ulcers will be infected and 20% will undergo amputation of their lower limb. The annual economic impact of chronic wounds, which includes nursing time and dressing materials, on the global economy is estimated to be ~£20 billion by 2030. A common practise in wound management is to cover wounds with suitable dressings to facilitate the healing process. Standard dressings, however, do not provide insights into the status of the wound underneath. Thus, dressings are often changed to examine and assess the wound. This in turn hampers the process of normal wound healing and cause stress and pain to patients. The assessment process also consumes a significant amount of nursing time and dressing materials, which contributes to spiralling medical costs in wound care. In addition, current treatment methods do not use physical or chemical feedback to modify or adjust the treatment based on wounds condition, and hence have limited success. It has been proposed to embed sensors in dressings to enable clinicians and nurses to make effective diagnostic and therapeutic wound management decisions without changing wound dressings; therefore improving patient comfort. Existing sensors, however, do not satisfy the operational (e.g. sensitivity, specificity) and physical (e.g. flexibility) characteristics required for embedding them in dressings. This project will develop a sensor system to overcome these limitations. The proposed sensor system will consist of a small laser that will emt light of different colour based on the concentration of a biomarker of interest in the fluid interface at the wound surface. The change in the colour of emitted light will be measured by waving a mobile device (e.g. phone, tablet) over the dressing containing the sensor system. The captured data will be transmitted to healthcare professionals, processed, stored to keep a record of wound history, and used for diagnostics and therapeutics. The proposed project will benefit patients by effective diagnostics and treatment of chronic wounds. The information on wound condition will permit timely identification of hard to heal wounds and will also be used to create a feedback loop for fully optimised treatments tailored to individual patients. For example, the rate of release of anti-inflammatory drugs will be tailored based on wound condition. This is critical in terms of chronic wound management, where it has been shown that the longer the delay in administering appropriate treatment, the more difficult a wound is to heal.


Dowsett C.,East London NHS Foundation Trust | 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.


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.


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.


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.

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