A wound is an injury, such as a cut or tear, to a part of the body. Usually these are external, and are known as ‘open’ wounds. However wounds can also be ‘closed’, for example bruises, with no external damage to the skin. Different kinds of wounds may be treated in different fashions, depending upon the cause and how serious they are. The treatment of such injuries is known as wound care, and has been practiced since prehistory. There is written evidence from 1500 B.C. of the use of lint, animal grease, and honey as topical treatments for wounds, which suggests considerable understanding of the process of healing. Further advances in wound care, such the introduction of antiseptic dressings in the mid 19th century, were driven by the understanding of the need to avoid infection. Such innovations contributed massively to improving mortality rates following surgery.
The medical technology industry has continued to advance the science of wound care and wound management. The introduction in the 1950s of synthetic fibres such as nylon, polyethylene and polyvinyls helped significantly accelerate natural wound healing processes. This was followed by "wet" polymer dressings, and research in the 1990s led to improvements in composite and hybrid polymers which further expanded the number of materials available for wound dressings.
The industry has developed increasingly specialised techniques for dealing with different types of wounds. For example, the treatment of burns has been revolutionised by advances in technology, and the number of people dying from burns has decreased significantly. The use of skin grafts and tissue engineering has changed the management and the outcomes for severe burns victims.
Another area of wound care which is particularly worrying is managing chronic non-healing wounds. These are extremely common amongst diabetes sufferers, where non-healing ulcers on the feet and lower legs occur in as many as one in six patients. Management is further complicated by the fact that diabetes also causes nerve damage, meaning sufferers may not be aware of their wounds. The wounds themselves need specialised and aggressive treatment; otherwise amputation can follow. It is estimated that every 30 seconds a lower limb is amputated somewhere in the world because of a diabetic wound not properly treated.
The cost to society of this condition cannot be overstated; amputation is often the trigger for a downward spiral of declining quality of life. In fact, only about one third of diabetic amputees will live more than five years, a survival rate equivalent to that of many cancers1. With the projected increase in diabetes, proper wound treatment and management is essential for both patients and healthcare systems.
Medical technologies have been specifically designed to address needs of patients with diabetic foot ulcers, which help them manage their condition effectively. Treatment can involve removing dead tissue, improving blood supply to the area and redistributing pressure. This involves a variety of different technologies, including highly absorbent dressings made from seaweed, special non-adhesive wound coverings and antimicrobial absorbent foam to reduce the likelihood of infection. In severe cases, synthetic skins have been developed to help rebuild damaged tissue.
The medical technology industry continues to invest and innovate in this field, improving quality of life and helping manage the growing burden of diabetes.
Public health budgets and wound care
In 2010, public spending on healthcare accounted for almost 15% of all government expenditure in Europe and the decade before the financial crisis, healthcare was one of the fastest growing spending items in almost all Member States.[i] Spending on wound care in Europe is approximately 2-4% of health expenditure with an average of €6.000 – €10.000 spent on each patient per year. [ii]
Costs for wound care are often driven by preventable factors. For example:
Investment in wound care technologies can make a real difference. Portable Negative Pressure Wound Therapy (NPWT) devices, for example, allow patients to return home to manage chronic wounds and heal faster. Not only does such a product improve health outcomes for patients, the investment in technology reduces the use of health services (particularly specialist and hospital care).
For more on how investment in NPWT and other wound care technologies can help people and health systems click here.
[i] OECD Health Data 2012.
[ii] Posnett, J et. al. Wound Care (April 2009), The Resource Impact of Wounds on Health-care Providers in Europe, vol. 18 (4).
[iv] Posnett, J., Franks, P.J, (2008) The burden of chronic wounds in the UK.Nursing Times; 104: 3, 44–45.
[v] Harold Brem, Jason Maggi, David Nierman, Linda Rolnitzky, David Bell, Robert Rennert, Michael Golinko, Alan Yan, Courtney Lyder, Bruce Vladeck, Am J Surg. High Cost of Stage IV Pressure Ulcers. Author manuscript; available in NIH Public Access, 2011 October 1. Note: “The average hospital treatment cost associated with stage IV pressure ulcers and related complications was $129,248 for hospital-acquired ulcers during one admission, and $124,327 for community-acquired ulcers over an average of 4 admissions. In addition, malpractice suits associated with the development of pressure ulcers, averaging $250,000 per settlement and reportedly accounting for a total of $65 million, were not included in the calculations.”