VENOUS LEG ULCER-COST BENEFIT OF MODERN APPROACH TO HEALING

Ivana VranjkovićOutpatient clinic for dermatology „Željko Pavičić, MD, PhD“, Zagreb

Dubravko Huljev, MD, PhDCH „Sveti Duh“, Zagreb

ntroduction

There are several types of chronic wounds, but most common chronic wounds are consequence of

venous insufficiency on the lower legs and the amounts of total is about 75% of all chronic

wounds.

ntroduction

ost of the treatment atient with venous ulcer re not negligible. On the vailable data from ifferent country's they ange from 1% to 3% total und allocated for health are.

o Expensive, long-term, painstakingly and often uncertain treatment isstill big, how in health so and as social and

Methods

n this study the verage duration of lcers in continuity

was 4 years, and the atients were treated

n several medical nstitution, as well and n primary care.

When the patients are admited in hospital?

Methods

Locally we started with application supporting dressing with Polyhexamethylene biguanide hydrochloride and compression therapy.

Two weeks after, we include negative pressure woundtherapy in period of 9 days, to prepare wound bed for surgical intervention.

Methods

er NPWT for next 4 days re applied collagen dressing order to further wound bed nditioning.

hen the local and crobiological wound status s satisfying, the patients re underwent to surgery.

cer were covered with thin n graft (Thiersh mesh graft :1) with immediately

plication of NPWT duringstoperative 5 days period.

Methods

Postoperative course was regular and graft was accepted in more than 95%.

After approximately two weeks of the initial surgery and rehabilitation of donor region, the second procedure under local anesthesia, the binding of the saphenous vein - inguinal crossectomy, was done.

Patients were dismissed from hospital with minimal residual defects which healed in next 2-3 weeks.

During this period, on this residual defect were applied alginate dressings and an elastic bandage.

The entire courses of treatment were photodocumentated, and wound images processed in a special computer software WoundManagerTM in order to verify the presence of types and quantities of tissues during treatments before mesh graft covering.

Results

oto 1. Photo 2.

Photo 3.

Results

impossible accurately assess the rent costs of 4 year treatment.y the price of supporting ssings were at least € 7,500 for ent.

we include all parameters (gaze, dages, solutions, medications ), then the overall cost of uccessful treatment of these ents certainly cost well in excess

he total amount of 33,000 €.

The cost of hospital (hospital days, surgical procedures and medications) was € 3,766.16.

The cost of consumables (supportive wound dressings, NPWT, set for compression therapy etc.) was € 2,459.71.

Total material cost of treatment, from initial examination to healed ulcers, was € 6,225.87 for all three patients.

cost of unsuccessful treatment: The cost of method we use:

Conclusion

In this example of a complex, multidisciplinary approach to patients with chronic venous leg

ulcer, based on the latest knowledge about treatment options, it has been proved that is

possible to significantly reduce the time and the cost of treatment, and consequently, reduce the number of patients with chronic venous ulcers.