Clinical Usage and Economic Effectiveness of a Recently Developed Epidermal Autograft Harvesting System in 13 Chronic Wound Patients in a University-Based Wound Center.
Identifieur interne : 000A07 ( PubMed/Checkpoint ); précédent : 000A06; suivant : 000A08Clinical Usage and Economic Effectiveness of a Recently Developed Epidermal Autograft Harvesting System in 13 Chronic Wound Patients in a University-Based Wound Center.
Auteurs : Angela Hulsey [États-Unis] ; Paul Linneman [États-Unis] ; Jeff Litt [États-Unis]Source :
- Cureus [ 2168-8184 ] ; 2016.
Abstract
Chronic wounds are a significant healthcare problem in the United States. Their costs approach 25 billion dollars in the United States. Current wound-care treatments of local wound care, moist dressings, and source control, while necessary for wound healing, are frequently not enough to ensure complete wound closure. The current surgical technique of split-thickness skin grafting is an operative procedure, painful, time-consuming, and leaves significant donor site wounds. A recently developed and marketed epidermal autograft harvester was tested at our university hospital wound center on 13 patients with wounds of various etiologies. Their clinical outcomes were evaluated, as were the costs associated with its usage compared with the potential costs of continued wound care without autograft placement.
DOI: 10.7759/cureus.878
PubMed: 28003942
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Their costs approach 25 billion dollars in the United States. Current wound-care treatments of local wound care, moist dressings, and source control, while necessary for wound healing, are frequently not enough to ensure complete wound closure. The current surgical technique of split-thickness skin grafting is an operative procedure, painful, time-consuming, and leaves significant donor site wounds. A recently developed and marketed epidermal autograft harvester was tested at our university hospital wound center on 13 patients with wounds of various etiologies. Their clinical outcomes were evaluated, as were the costs associated with its usage compared with the potential costs of continued wound care without autograft placement.</div></front></TEI><pubmed><MedlineCitation Status="PubMed-not-MEDLINE" Owner="NLM"><PMID Version="1">28003942</PMID><DateCreated><Year>2016</Year><Month>12</Month><Day>22</Day></DateCreated><DateRevised><Year>2017</Year><Month>02</Month><Day>24</Day></DateRevised><Article PubModel="Electronic"><Journal><ISSN IssnType="Print">2168-8184</ISSN><JournalIssue CitedMedium="Print"><Volume>8</Volume><Issue>11</Issue><PubDate><Year>2016</Year><Month>Nov</Month><Day>14</Day></PubDate></JournalIssue><Title>Cureus</Title><ISOAbbreviation>Cureus</ISOAbbreviation></Journal><ArticleTitle>Clinical Usage and Economic Effectiveness of a Recently Developed Epidermal Autograft Harvesting System in 13 Chronic Wound Patients in a University-Based Wound Center.</ArticleTitle><Pagination><MedlinePgn>e878</MedlinePgn></Pagination><ELocationID EIdType="doi" ValidYN="Y">10.7759/cureus.878</ELocationID><Abstract><AbstractText Label="INTRODUCTION" NlmCategory="BACKGROUND"> Chronic wounds are a significant healthcare problem in the United States. Their costs approach 25 billion dollars in the United States. Current wound-care treatments of local wound care, moist dressings, and source control, while necessary for wound healing, are frequently not enough to ensure complete wound closure. The current surgical technique of split-thickness skin grafting is an operative procedure, painful, time-consuming, and leaves significant donor site wounds. A recently developed and marketed epidermal autograft harvester was tested at our university hospital wound center on 13 patients with wounds of various etiologies. Their clinical outcomes were evaluated, as were the costs associated with its usage compared with the potential costs of continued wound care without autograft placement.</AbstractText><AbstractText Label="METHODS" NlmCategory="METHODS"> Thirteen patients whose wounds appeared to have "stalled" or reached a plateau in healing by measurement data and visual evidence were chosen to receive an epidermal autograft to accelerate wound closure. Wound-types included diabetic ulcers, venous or lymphedema-related ulcers, surgical site wounds, and traumatic wounds. Time-to-healing in days, when applicable, was captured. Wound center billing and charges were available and evaluated for nine of the 13 patients. Costs of standard care continuation compared with the cost of epidermal autograft technology usage were compared.</AbstractText><AbstractText Label="RESULTS" NlmCategory="RESULTS"> Healing rates were 62%; eight of the 13 patients had healed within four months, two were lost to follow-up, and three have wounds that remain open. Four of the patients healed in less than one month. The comparatively rapid closure of the open wound(s) post-epidermal autograft placement potentially reduced healthcare costs based on charges at an average of $1,153 per patient and yielded an average of $650 to the wound center, not applying the routine costs of dressings applied in the center. Conclusion: The epidermal autograft harvester accelerated healing in eight of the 13 of the patients (62%) we treated at the time of the writing of this article. By accelerating wound healing in our patient population, costs associated with subsequent wound care seem to have decreased to a dramatic degree and wound center finances have improved. No wound recurrence has been noted once the wounds had healed in our year-long experience with the technology. In addition, the procedure has been well-tolerated and easy to perform. Given the improved outcomes, cost-savings, and a better financial outlook for the wound center, utilization of the novel epidermal autograft harvester is proving itself to be in the "win-win" category of wound care treatments.</AbstractText></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Hulsey</LastName><ForeName>Angela</ForeName><Initials>A</Initials><AffiliationInfo><Affiliation>Medical Student, University of Missouri, Columbia, Missouri.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Linneman</LastName><ForeName>Paul</ForeName><Initials>P</Initials><AffiliationInfo><Affiliation>Surgery ICU, University of Missouri, Columbia, Missouri.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Litt</LastName><ForeName>Jeff</ForeName><Initials>J</Initials><AffiliationInfo><Affiliation>Division of Acute Care Surgery, University of Missouri, Columbia, Missouri.</Affiliation></AffiliationInfo></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2016</Year><Month>11</Month><Day>14</Day></ArticleDate></Article><MedlineJournalInfo><Country>United States</Country><MedlineTA>Cureus</MedlineTA><NlmUniqueID>101596737</NlmUniqueID><ISSNLinking>2168-8184</ISSNLinking></MedlineJournalInfo><CommentsCorrectionsList><CommentsCorrections RefType="Cites"><RefSource>Wound Repair Regen. 2009 Nov-Dec;17(6):763-71</RefSource><PMID Version="1">19903300</PMID></CommentsCorrections><CommentsCorrections RefType="Cites"><RefSource>Arch Dermatol. 1994 Apr;130(4):489-93</RefSource><PMID Version="1">8166487</PMID></CommentsCorrections><CommentsCorrections RefType="Cites"><RefSource>Adv Skin Wound Care. 2016 Feb;29(2):65-72</RefSource><PMID Version="1">26765158</PMID></CommentsCorrections><CommentsCorrections RefType="Cites"><RefSource>Adv Skin Wound Care. 2016 Feb;29(2):57-64</RefSource><PMID Version="1">26765157</PMID></CommentsCorrections><CommentsCorrections RefType="Cites"><RefSource>J Wound Care. 2015 Apr;24(4 Suppl):30-4</RefSource><PMID Version="1">25853646</PMID></CommentsCorrections><CommentsCorrections RefType="Cites"><RefSource>Plast Reconstr Surg. 2015 Oct;136(4):524e-30e</RefSource><PMID Version="1">26397272</PMID></CommentsCorrections></CommentsCorrectionsList><KeywordList Owner="NOTNLM"><Keyword MajorTopicYN="N">chronic wound</Keyword><Keyword MajorTopicYN="N">diabetic ulcer</Keyword><Keyword MajorTopicYN="N">epidermal autograft</Keyword><Keyword MajorTopicYN="N">epidermal blister</Keyword><Keyword MajorTopicYN="N">lymphedema wound</Keyword><Keyword MajorTopicYN="N">venous ulcer</Keyword><Keyword MajorTopicYN="N">wound healing</Keyword></KeywordList><CoiStatement>The authors have declared that no competing interests exist.</CoiStatement></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="entrez"><Year>2016</Year><Month>12</Month><Day>23</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="pubmed"><Year>2016</Year><Month>12</Month><Day>23</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>2016</Year><Month>12</Month><Day>23</Day><Hour>6</Hour><Minute>1</Minute></PubMedPubDate></History><PublicationStatus>epublish</PublicationStatus><ArticleIdList><ArticleId IdType="pubmed">28003942</ArticleId><ArticleId IdType="doi">10.7759/cureus.878</ArticleId><ArticleId IdType="pmc">PMC5158185</ArticleId></ArticleIdList></PubmedData></pubmed><affiliations><list><country><li>États-Unis</li></country><region><li>Missouri (État)</li></region></list><tree><country name="États-Unis"><region name="Missouri (État)"><name sortKey="Hulsey, Angela" sort="Hulsey, Angela" uniqKey="Hulsey A" first="Angela" last="Hulsey">Angela Hulsey</name></region><name sortKey="Linneman, Paul" sort="Linneman, Paul" uniqKey="Linneman P" first="Paul" last="Linneman">Paul Linneman</name><name sortKey="Litt, Jeff" sort="Litt, Jeff" uniqKey="Litt J" first="Jeff" last="Litt">Jeff Litt</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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