Here - EWMA 2013

E-POSTER PRESENTATIONS
EP 504
E-Poster: Health Economics & Outcome
ECONOMICAL COMPARISON BETWEEN THREE DIFFERENT TYPES OF
DEBRIDEMENT (AUTOLYTIC AND ENZYMATIC VS MECHANICAL DEBRIDEMENT
WITH POLYESTER FIBRES)
Renato Pietroletti 1 , Ivano Capriotti 2 , Raffaele Di Nardo 3 , Paolo Mascioli 4 , Maria
Gonzalez 5 , Paola Ermolli 6
1 University of l’Aquila- Hospital Val Vibrata (Sant’Omero (TE), Italy);
2 Surgery (Sant’Omero, Italy);
3 ASL Lanciano (Lanciano (Switzerland), Italy);
4 ASL Pescara (Pescara, Italy);
5 Horizon Service (Pescara, Italy);
6 Lohmann&Rauscher (Padova, Italy).
Introduction: Not every debridement technique is effective, safe, cost-effective. In
home care and in the first-level-hospital, adequate debridement could be a problem;
Italian nurses use autolytic, enzymatic, mechanical methods, requiring several
accesses. In a first-level-hospital, the surgical debridement may be difficult. A new
method – polyester monofilament fibres debrider*- allows fast, almost painless, effective
debridement in sloughy, fibrinous wounds and in peri-wound skin: we demonstrate that
this debrider* is effective, safe, cost effective.
Methods: 27 patients (average age 76) with ulcers of various aetiology were treated.
This prospective documented group was compared with another group (25 patients,
average age 78), retrospectively. The wounds were fibrinous, sloughy; periwound with
keratosis, desiccated exudate or dressing; max area of wounds approx 60cm2. The
costs at home includes: time, all materials.
Results: The mean cost for single use were similar in both groups (mean: € 30,29
autolytic; € 35,54 debrider*), the results were different (best for debrider*). One use of
the debrider gives a mean of 92% of debrided tissue, 2 uses of autolytic gives 38.4%.
The autolytic requires 8-10 times to give the same results as the debrider*. Using the
debrider* 1 time, the cost saving would be approx € 115 when compared with 5 times
using autolytic. The costs for similar results are lower with the debrider*.
Conclusions: This debrider* is a very fast, effective, safe method to debride wounds in
the homecare / ambulant area; it cares the granulation, it helps to remove bacteria and
is not expensive.
E-POSTER: HEALTH ECONOMICS & OUTCOME
EP 505
EFFICIENCY IN TACKLING WOUNDS
E-Poster: Health Economics & Outcome
Ana Maria Calvo 1 , Carmen Alba 2 , Raquel Contreras 3 , Esther Armans 4
1Hospital Universitario de Salamanca (Salamanca, Spain);
2 Hospital Clínico de Valencia (Valencia, Spain);
3 Centro de Salud Inmaculada Vieira (Sevilla, Spain);
4 Hospital Clinic (Barcelona, Spain).
Introduction: The Spanish National Health Service (NHS) allocates an 8.5% GDP to
attend more than 46 million people, and spends more than 6% of this money in patients
carriers of wounds. In the current crisis, is debated the future of provisions and
sustainability, therefore, the Spanish Association of Vascular Nursing and Wounds
(AEEVH) raises this study
Objectives: Describe Spanish NHS resources offered to patients with wounds of lower
limb. Evaluate the cost-effectiveness of cares offered to people with wounds of lower
limb
Material and Methods: Descriptive study of Spanish public resources for patients with
wounds of lower limbs and cost-benefit assessment
Results: There is variability of human and material resources in the 17 regions, 254
hospitals, 2914 health centers and 10,202 consultancies. Telemedicine is available at
hospitals and health centers. Most of professionals who care for patients with wounds do
not have access to costs. The waiting time for the specialist is more than 50 days.
Currently there are 7 units of wounds, led by expert nurses in wounds that support
integrated care streamlining the coordination of professionals and assistance levels
Conclusion: The resources offered in the Spanish NHS to patients with wounds of lower
limbs, are different depending on where the patient lives. Wounds units in Spain have
allowed better understanding of costs and maximization of resources, ensuring a
comprehensive approach, faster and easier. Therefore, this type of units, led by expert
nurses, is emerging as an efficient tool.
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