Horch R E, Nord D, Augustin M, Germann G, Leffler M, Dragu A
Plastische und Handchirurgische Klinik, Universitätsklinikum Erlangen, Krankenhausstrasse 12, 91054, Erlangen, Deutschland.
Chirurg. 2008 Jun;79(6):518-25. doi: 10.1007/s00104-008-1500-3.
Health care insurers in Germany pay 5 billion Euros annually in materials alone for pressure ulcers, diabetic foot ulcers, and ulcus cruris. With such figures it is necessary to consider, economic aspects of treatment.
Due to the lack of evidence-based data on wound treatment costs, we investigated available studies for an effect on treatment costs when standard moist wound therapy was compared with alternative methods. Suited medical parameters are calculated and compared. Daily costs and length of treatment are correlated and compared.
Published data show that alternative wound therapies may lead to an earlier wound closure, fewer complications, and reduction in hospital admissions and length of stay. Despite higher daily costs, some alternative wound therapies turn out to be more cost effective, when all economical factors are considered. In this respect a move towards alternative wound therapies could possibly lead to major savings.
At present there is insufficient evidence to prove the efficacy of various treatment modalities for chronic wounds. This is due to numerous factors such as comorbidities and frequent multimorbidity. Nevertheless critical evaluation of one innovative treatment alone already uncovered an enormous potential for savings in a wider economic context, despite the comparatively higher cost of a single treatment. It is of utmost importance that conservative wound care become firmly embedded in surgical concepts.
德国的医疗保险公司每年仅在压疮、糖尿病足溃疡和静脉曲张性溃疡的材料方面就支付50亿欧元。鉴于这些数字，有必要考虑治疗的经济方面。
由于缺乏关于伤口治疗成本的循证数据，我们调查了现有研究，以比较标准湿性伤口疗法与其他方法对治疗成本的影响。计算并比较合适的医学参数。对每日成本和治疗时长进行关联和比较。
已发表的数据表明，替代伤口疗法可能会使伤口更早愈合，并发症更少，并减少住院次数和住院时长。尽管每日成本较高，但在考虑所有经济因素时，一些替代伤口疗法的性价比更高。在这方面，转向替代伤口疗法可能会带来大幅节省。
目前，尚无足够证据证明各种慢性伤口治疗方式的疗效。这是由多种因素造成的，如合并症和频繁的多种合并症。然而，仅对一种创新治疗进行批判性评估就已发现，尽管单一治疗成本相对较高，但在更广泛的经济背景下仍有巨大的节省潜力。至关重要的是，保守伤口护理应牢固地融入手术理念中。
