Hard-to-heal wounds Resources

This case series evaluation assessed the efficacy of WoundExpress™ (Huntleigh Healthcare), a novel IPC device, which applies compression to the thigh of the afflicted leg for the management of hard-to-heal leg ulcers. Eleven wound treatment centres or wound care specialists undertook WoundExpress evaluations. Eligible and willing patients (n=61), with a ‘hard-to heal’ leg ulcer used the WoundExpress device for two hours a day, in addition to continuing to receive their standard wound care for a 16-week period. Fifty-three participants completed the evaluations. Thirty-three percent (n=19) of all ulcers healed within the 16-week study period; the mean time to healing was 10 weeks. A further 60% of ulcers (n=35) progressed towards healing within the 16-week period, with a mean surface area reduction of 56% (23cm2). The evaluation concluded that thigh-administered IPC is an effective adjunctive treatment, that aids healing and reduces pain, for patients with hard to heal leg ulcers.

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.