Cost-effective use of silver dressings for the treatment of hard-to-heal chronic venous leg ulcers

Gregor B E Jemec, Jean Charles Kerihuel, Karen Ousey, Sanne Lise Lauemløler, David John Leaper

Research output: Contribution to journalArticle

12 Citations (Scopus)

Abstract

Aim: To estimate the cost-effectiveness of silver dressings using a health economic model based on time-to-wound-healing in hard-to-heal chronic venous leg ulcers (VLUs). Background: Chronic venous ulceration affects 1-3% of the adult population and typically has a protracted course of healing, resulting in considerable costs to the healthcare system. The pathogenesis of VLUs includes excessive and prolonged inflammation which is often related to critical colonisation and early infection. The use of silver dressings to control this bioburden and improve wound healing rates remains controversial. Methods: A decision tree was constructed to evaluate the cost-effectiveness of treatment with silver compared with nonsilver dressings for four weeks in a primary care setting. The outcomes: 'Healed ulcer', 'Healing ulcer' or 'No improvement' were developed, reflecting the relative reduction in ulcer area from baseline to four weeks of treatment. A data set from a recent meta-analysis, based on four RCTs, was applied to the model. Results: Treatment with silver dressings for an initial four weeks was found to give a total cost saving (£141.57) compared with treatment with non-silver dressings. In addition, patients treated with silver dressings had a faster wound closure compared with those who had been treated with non-silver dressings. Conclusion: The use of silver dressings improves healing time and can lead to overall cost savings. These results can be used to guide healthcare decision makers in evaluating the economic aspects of treatment with silver dressings in hard-to-heal chronic VLUs.

Original languageEnglish
Article numbere100582
JournalPLoS One
Volume9
Issue number6
DOIs
Publication statusPublished - 19 Jun 2014

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Varicose Ulcer
Leg Ulcer
Bandages
Silver
silver
legs
Costs and Cost Analysis
cost effectiveness
Costs
Ulcer
Cost effectiveness
tissue repair
health services
Therapeutics
Wound Healing
Cost-Benefit Analysis
Economics
microbial load
econometric models
plant damage

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Jemec, Gregor B E ; Kerihuel, Jean Charles ; Ousey, Karen ; Lauemløler, Sanne Lise ; Leaper, David John. / Cost-effective use of silver dressings for the treatment of hard-to-heal chronic venous leg ulcers. In: PLoS One. 2014 ; Vol. 9, No. 6.
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Cost-effective use of silver dressings for the treatment of hard-to-heal chronic venous leg ulcers. / Jemec, Gregor B E; Kerihuel, Jean Charles; Ousey, Karen; Lauemløler, Sanne Lise; Leaper, David John.

In: PLoS One, Vol. 9, No. 6, e100582, 19.06.2014.

Research output: Contribution to journalArticle

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AB - Aim: To estimate the cost-effectiveness of silver dressings using a health economic model based on time-to-wound-healing in hard-to-heal chronic venous leg ulcers (VLUs). Background: Chronic venous ulceration affects 1-3% of the adult population and typically has a protracted course of healing, resulting in considerable costs to the healthcare system. The pathogenesis of VLUs includes excessive and prolonged inflammation which is often related to critical colonisation and early infection. The use of silver dressings to control this bioburden and improve wound healing rates remains controversial. Methods: A decision tree was constructed to evaluate the cost-effectiveness of treatment with silver compared with nonsilver dressings for four weeks in a primary care setting. The outcomes: 'Healed ulcer', 'Healing ulcer' or 'No improvement' were developed, reflecting the relative reduction in ulcer area from baseline to four weeks of treatment. A data set from a recent meta-analysis, based on four RCTs, was applied to the model. Results: Treatment with silver dressings for an initial four weeks was found to give a total cost saving (£141.57) compared with treatment with non-silver dressings. In addition, patients treated with silver dressings had a faster wound closure compared with those who had been treated with non-silver dressings. Conclusion: The use of silver dressings improves healing time and can lead to overall cost savings. These results can be used to guide healthcare decision makers in evaluating the economic aspects of treatment with silver dressings in hard-to-heal chronic VLUs.

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