Jwc ewma final indd

J O U R N A L  O F WO U N D  C A R E   Vo l   2 2 .  N o   1 .  E W M A   D o c u M E N t   2 0 1 3  

S 3 5

Healtheconomics:

Woundmanagement

anddebridement

T

he distinctive feature of an economic 

approach to the evaluation of health-

care interventions is that it involves 

explicit consideration of both the costs and the 

outcomes, or consequences, of an intervention. 

When resources are scarce, it is not appropriate 

to make choices on the basis of patient outcomes 

alone, since maximising benefits for one group 

of patients may mean fewer benefits for others. 

With a fixed budget, spending money on an 

expensive treatment that heals wounds faster 

may simply mean that it is possible to treat fewer 

patients in total. Economic evaluation takes 

account of the benefits as well as the costs of an 

intervention, measured in terms of the value of 

other opportunities forgone.

During recent years, positive examples have 

illustrated the possibilities to reduce both resource 

utilisation and costs, alongside important 

improvements in health-related quality of life 

for affected patients. Successful projects are often 

associated with a broader perspective including, 

not only the costs of dressings and other material, 

but also costs of staff resources, frequency of 

dressing changes, total time to healing and 

quality of life. Several cases have also focused  

on education of physicians and nurses, together 

with more effective management of ulcers as 

fruitful actions.

From the resource utilisation point of view it is 

essential to analyse debridement as an integrated 

part of wound management to achieve a specific 

end point, such as healing. Currently these 

aspects of the various debridement techniques 

have not been thoroughly examined.

Thus, this introduction to the health economy 

of debridement will not go in to detail regarding 

the cost effectiveness of various techniques, 

but instead focus on the overall structures of 

costs, with a reference to existing literature on 

debridement and non-healing wounds. 

Health economics and  

factors related to healing  

of non-healing wounds

In patients with hard-to-heal diabetic foot ulcers 

(those with deep foot infections), the dominating 

factors related to high cost have been identified 

as the number of surgical procedures, length 

---

S 3 6