Here - EWMA 2013

E-POSTER: HEALTH ECONOMICS & OUTCOME
E-Poster: Health Economics & Outcome
EP 502
EVALUATION OF THE USE OF A POINT OF CARE TEST FOR PROTEASES TO
IDENTIFY PATIENTS WITH INCREASED RISK OF SKIN GRAFT FAILURE
Franck Duteille 1
1 Service des Brulés CHU Nantes (Nantes, France).
Aims: In chronic wounds, proteolytic environment persists, degrading proteins of the
extracellular matrix. A new point of care diagnostic test for elevated protease activity
(EPA)* is now available. According to a recently published study, EPA is associated with
a 90% probability of non-healing. This study was designed to evaluate the value of this
test to identify chronic wounds with an increased risk of graft failure.
Methods: The study aims to recruit 30 chronic wounds, of which the quality of the bed
of the wound is considered by one senior surgeon of the team good enough to perform a
skin graft. All the wounds are assessed using the new protease test in the operating
room before the graft procedure is performed. All receive a meshed dermo-epidermal
thin graft with standard follow up treatment. Of the wounds, the ones with EPA are
assigned to group 1 and the ones with low protease activity to group 2. The percentage
graft ‘take rate’ is recorded by the same surgeon at Day 3 and 8 using standard criteria.
Results: For the 20 wounds which have been followed up to date, the success rate was
0% (0/3) in group 1 and 94% (16/17) in group 2.
Conclusions: We can conclude that the protease test evaluated is a very interesting
predictive and objective test to help the surgeon in his decision whether or not to carry
out a graft procedure, which is very interesting from both a clinical and economical point
of view.
*WOUNDCHEK Protease Status
EP 503
E-Poster: Health Economics & Outcome
QUANTIFYING THE ECONOMIC VALUE OF DIAGNOSTICS IN WOUND CARE IN
THE UK
Louise Digby 1 , Paolo Di Vincenzo 1 , Jane Clark 1 , Chris Gilpin 1 , Leo Nherera 1
1 Systagenix (Gatwick, United Kingdom).
Aim: Chronic wounds present a significant financial and resource burden to the NHS.
The annual cost of wound care in the UK has been estimated to be £2 million per
100,000 population. A recent study found that 28% of all non-healing chronic wounds
had EPA (elevated protease activity), which can now be assessed using a new point of
care protease test*, and that these wounds had only a 10% chance of healing without
appropriate intervention. A separate study showed that 77% of venous leg ulcers
responded to Collagen/ORC therapies, when targeted to wounds with EPA. This work
aimed to quantify the economic value of testing for EPA and targeting treatment
accordingly.
Methods: An economic model was developed to calculate the potential saving that could
be achieved by identifying chronic wounds with EPA and targeting protease modulating
treatment** accordingly. Published effectiveness data and UK relevant resource use data
were used to populate the model.
Results: The model estimated potential savings of £1,906 per EPA wound identified
when compared to usual care. This equates to over £50,000 for every 100 non-healing
chronic wounds tested.
Conclusions: The model demonstrates that implementing a ‘test and treat’ algorithm of
care in the UK involving testing for EPA and targeting protease modulating treatment
accordingly can achieve savings while dramatically improving the healing chances of
EPA wounds, thus confirming previously published consensus opinion on this topic.
*WOUNDCHEK Protease Status
**PROMOGRAN ® / PROMOGRAN PRISMA ®
EWMA 2013
COPENHAGEN
15-17 May · 2013
Danish Wound
Healing Society
287