Lavery Lawrence A, Boulton Andrew J, Niezgoda Jeffrey A, Sheehan Peter
Texas A&M Health Science Center College of Medicine, Department of Surgery, Scott and White Hospital, Temple, TX 78628, USA.
Int Wound J. 2007 Jun;4(2):103-13. doi: 10.1111/j.1742-481X.2007.00317.x.
Diabetic foot ulcers (DFUs) are a leading cause of morbidity and hospitalisation among patients with diabetes. We analysed claims data for Medicare part B diabetic foot ulcer patients treated with Negative Pressure Wound Therapy at home (N = 1135) and diabetic foot ulcer patients from a published meta-analysis of randomised controlled wet-to-moist therapy. The expected costs of care for the two treatments were also compared. A significantly greater proportion of wounds treated with NPWT achieved a successful treatment endpoint compared with wet-to-moist therapy at both 12 weeks (39.5% versus 23.9%; P < 0.001) and 20 weeks (46.3% versus 32.8%; P < 0.001). NPWT-treated patients reached a successful wound treatment endpoint more rapidly, and the benefit was apparent in all wound sizes. Expected 20-week treatment costs for NPWT were similar to those for wet-to-moist therapy if one nursing visit per day for the latter is assumed but 42% less if two nursing visits per day are made. Thus, NPWT may improve the proportion of DFUs that attain a successful wound treatment endpoint and decrease resource utilisation by a given health care system compared with standard wet-to-moist therapy.
糖尿病足溃疡(DFU)是糖尿病患者发病和住院的主要原因。我们分析了医疗保险B部分在家接受负压伤口治疗的糖尿病足溃疡患者(N = 1135)的索赔数据,以及已发表的随机对照湿对湿疗法荟萃分析中的糖尿病足溃疡患者数据。还比较了两种治疗方法的预期护理成本。与湿对湿疗法相比,在12周时(39.5%对23.9%;P < 0.001)和20周时(46.3%对32.8%;P < 0.001),接受负压伤口治疗的伤口达到成功治疗终点的比例显著更高。接受负压伤口治疗的患者更快达到成功的伤口治疗终点,且这种益处对所有伤口大小均明显。如果假设湿对湿疗法每天进行一次护理访视,负压伤口治疗的预期20周治疗成本与之相似,但如果每天进行两次护理访视,则负压伤口治疗的成本低42%。因此,与标准的湿对湿疗法相比,负压伤口治疗可能提高糖尿病足溃疡达到成功伤口治疗终点的比例,并减少特定医疗保健系统的资源利用。