Create successful ePaper yourself
Turn your PDF publications into a flip-book with our unique Google optimized e-Paper software.
POSTER PRESENTATIONS<br />
P 246<br />
Poster: Devices & Intervention<br />
PRACTICAL MANAGEMENT OF THE NEWBORN INFANT WITH SEVERE<br />
EPIDERMOLYSIS BULLOSA (EB)<br />
Jackie Denyer 1<br />
1 Great Ormond Street Hospital and DEBRA UK (London, United Kingdom).<br />
Epidermolysis bullosa (EB) comprises a group of genetically determined skin fragility<br />
disorders. In its severe forms EB can be progressively disabling or even fatal in infancy.<br />
Affected newborn infants may present with extensive wounds.<br />
Aim: Management of the newborn infant with EB is challenging and potentially harmful if<br />
recommended principles of care and established guidelines are not followed.<br />
This poster will describe trusted methods of skin and wound care with guidance for<br />
adapting dressing technique to comply with minimal handling restrictions.<br />
Methods: Guidelines for care of the severely affected infant were followed to promote<br />
correct methods of handling and care of both intact and broken skin. Practical solutions<br />
to reduce duration of dressing changes and safe fixation of dressings in this age group<br />
were employed. Correct method of handling the fragile infant and feeding techniques<br />
were taught to care-givers.<br />
Factors considered include:<br />
Ease of application and removal of dressing materials<br />
Duration of dressing changes<br />
Healing<br />
Pain control (using Neonatal Infant Pain Scale)<br />
Minimal trauma from handling<br />
Adequate nutritional intake<br />
Results: Using the newborn guidelines correctly minimized trauma from handling and<br />
promoted wound healing. Trauma from handling was minimal and oral feeding<br />
established.<br />
Conclusion: Correct management of the severely affected newborn with EB can<br />
minimize trauma and promote healing. Following neonatal guidelines can accomplish<br />
safe care outside of specialized centers.<br />
POSTER: DEVICES & INTERVENTION<br />
P 247<br />
Poster: Devices & Intervention<br />
COST-EFFECTIVENESS OF LIQUID OF NON-BIODEGRADABLE MICROSPHERES<br />
COMPARED TO SURGERY IN MANAGING CHRONIC WOUNDS WITH EXPOSED<br />
BONES AND/OR TENDONS ARISING FROM TRAUMA IN FRANCE, GERMANY AND<br />
THE UK<br />
Julian F Guest 1,2 , Erikas SlaDenmarkevicius 1 , Monica Panca 1<br />
1 Catalyst Health Economics Consultants (Northwood, United Kingdom);<br />
2 School of Biomedical Sciences, King’s College (London, United Kingdom).<br />
Objective: To assess the cost-effectiveness of liquid of non-biodegradable microspheres<br />
compared to surgery in treating chronic wounds with exposed bones and/or tendons<br />
(EB&T) arising from trauma in France, Germany and the UK, from the perspective of the<br />
payers.<br />
Method: Decision models were constructed depicting the management of chronic<br />
wounds with EB&T and spanned the period up to healing or up to one year. The models<br />
considered the decision by a plastic surgeon to initially treat these wounds with liquid of<br />
non-biodegradable microspheres or surgery and was used to estimate the relative costeffectiveness<br />
of liquid of non-biodegradable microspheres at 2010/11 prices.<br />
Results: Initial use of liquid of non-biodegradable microspheres instead of surgery is<br />
expected to increase the probability of healing from 0.93 to 0.98 and lead to a total<br />
healthcare cost of €7,984, €7,517 and €8,860 per patient in France, Germany and the<br />
UK respectively. Initial management with surgery is expected to lead to a total healthcare<br />
cost of €12,300, €18,137 and €11,330 per patient in France, Germany and the UK<br />
respectively. Hence, initial treatment with liquid of non-biodegradable microspheres<br />
instead of surgery is expected to lead to a 5% improvement in the probability of healing<br />
and a substantial decrease in healthcare costs of 35%, 59% and 22% in France,<br />
Germany and the UK respectively. Additionally, at a cost-effectiveness threshold of as<br />
low as €1 for each additional patient healed with liquid of non-biodegradable<br />
microspheres, it is likely that up to 99%, 90% and 85% of a cohort would be costeffectively<br />
treated with liquid of non-biodegradable microspheres in Germany, France<br />
and the UK respectively.<br />
Conclusion: Within the models’ limitations, liquid of non-biodegradable microspheres<br />
potentially affords the public healthcare system in France, Germany and the UK a costeffective<br />
treatment for chronic wounds with EB&T arising from trauma, when compared<br />
with surgery (since it improves the probability of healing for less cost). However, this<br />
finding will be dependent on liquid of non-biodegradable microspheres´s healing rate in<br />
clinical practice when liquid of non-biodegradable microspheres becomes routinely<br />
available.<br />
152
Change language