NPWT Resources

A recent economic analysis has reported a £8.3 billion cost to the NHS for wound management. This overwhelming cost has meant alternate wound management strategies are needed. One example is a Hospital @ Home (H@H) negative pressure wound therapy (NPWT) service, whereby patients are discharged from hospital with an open wound and traditional NPWT (tNPWT) and/or single-use (sNPWT) is provided in their own home. The aim of the service evaluation presented here, which was conducted from the H@H nurse base within Brighton General Hospital, was to highlight the clinical outcomes of utilising NPWT in a homecare setting, to assess changes in patient quality of life through a validated instrument, and to understand the anticipated cost savings to the NHS. Thirty-one patients, all of whom had received surgical intervention resulting in an open wound requiring NPWT and were receiving H@H NPWT, were included in the evaluation. A statistically significant reduction in wound dimentions and improvement in patient reported general quality of life was found. Overall, the delivery of this H@H NPWT service enables patients to return home, with ongoing wound management which results in wound closure. The service evaluation also enabled a cost saving analysis to be reported, suggesting that this locally implemented H@H service can reduce costs of approximately £5,256 per patient by utilising H@H NPWT compared to hospital inpatient managed NPWT.

Hard-to-heal wounds are challenging to manage and incur a cost burden to healthcare systems through extended treatment periods, resource use and patient quality of life. The aim of the service evaluation presented here was to determine the wound healing and health economic impact of using PICO™ Single Use Negative Pressure Wound Therapy (sNPWT) on hard-to-heal wounds at seven centres across Northern Ireland and the Republic of Ireland. Patients with clinically defined hard-to-heal wounds received PICO sNPWT, as per a clinician-endorsed PICO sNPWT hard-to-heal pathway (Dowsett et al, 2017). Wounds were assessed for their healing trajectory over a 12-week period. Of wounds included (n=36), 20 (55.6%) healed within the 12-week routine follow-up period. Wounds of <3 months’ duration reported a significantly higher healing rate compared to wounds with a duration of >3 months (p=0.0125). Dressing-change frequency significantly reduced during PICO sNPWT treatment compared to the standard dressing regime before the evaluation (p<0.001). Furthermore, dressing change frequency remained significantly reduced after PICO sNPWT treatment was introduced, when compared to the pre-pathway standard dressing regimen (p<0.001). Health economic modelling suggested a cost-saving of 21% (€12,001) for the Republic of Ireland, and 25% (£15,467) in Northern Ireland, by using the PICO sNPWT hard-toheal pathway compared to standard wound management.