Reducing Cost and Improving Outcomes of Chronic Wound Care

The number of Australians living with chronic wounds is rising and becoming a significant public health issue. Embracing innovation can help overcome this challenge.

A Growing Public Health Issue

An estimated 450,000 Australians are suffering from chronic wounds and the public healthcare cost of treating these wounds reaching over $6.6 billion every year¹. As the average age of those with hard-to-heal wounds is 60 and over², and with Australia’s ageing population, the forecasted burden to the healthcare budget will continue to grow.

There is also a substantial personal cost of living with chronic wounds. Not only is there an estimated out-of-pocket expense of $4,000 a year, but living with a chronic wound can also severely impact a person’s quality of life, causing long-term pain, decreased mobility, and reduced physical and mental well-being³.

Costs Loaded in Hospitalisation and Nursing Time

It would come as no surprise to wound care clinicians that most of the costs associated with treating chronic wounds are not in healthcare consumables, but with the costs associated with hospitalisation and community nursing. A European study found that up to 85% of the total cost of treating a chronic wound could be attributed to hospital admissions and nursing time⁴. A UK study also found that 81% of total wound care costs to the NHS are primarily driven by community nurse visits and follow-up healthcare assistant visits⁵. An Australian study also reported that patients living with leg ulcers needed support from an average of three (with a range of two to seven) healthcare providers involved in their care⁶.

Microbial Bioburden: Disruptor to Healing

A chronic wound can be defined as a wound that fails to progress through the phases of healing in an orderly and timely process within four weeks⁷. Biofilm infection can be found in up to 80%⁸ of chronic wounds and is a significant factor in delayed healing⁹.

Biofilm microbes are formed as complex structures, embedded in a protective matrix, that adhere to surfaces and are protected from the immune system and many antimicrobial agents. Wound biofilm can cause chronic inflammation and impaired healing. The host immune system fails to remove biofilm components, leading to delayed wound closure and weakened tissue regeneration^9,10.

Current Standard for Treating Chronic Wounds

To facilitate healing, it is accepted practice to debride the slough and devitalised tissue and remove the biofilm. This then prepares the wound bed and fosters an environment conducive to healing. Physical removal of wound biofilm through surgical or conservative sharp debridement are the current mainstays of treatment¹⁰.

Some debridement methods can, however, present a challenge in the community setting. They can require specialist training, repetitive treatments or even hospitalisation. Without complete removal, the microbial bioburden in a wound can continue to disrupt the healing process, necessitating further treatments and ongoing care¹⁰.

This then impacts the direct costs involved in delivering care, including ongoing nursing time, healthcare consumables, hospital admissions, potential emergency visits, and even surgical costs. To help resolve this growing problem, we can look to innovation to support strained budgets and reduce patient suffering.

Innovation in Wound Debridement

Debridement using a Topical Desiccating Agent is a pioneering solution that has been recognised internationally as an accepted adjunct method to wound debridement and is included in the International Journal of Wound Care, Best Practice for Wound Debridement 2024 Consensus Document⁹.

Topical Desiccating Agent DEBRICHEM® completely removes the microbial bioburden in infected, non-surgical wounds with a single, rapid application. It works by drawing out moisture from the biofilm which has a high-water (97%) content, generating an exothermic reaction and causing microbial death¹¹.

After application, the precipitate and biofilm slough off over several days, preparing the wound for healing. Complete removal of the microbial bioburden allows the wound to continue towards a normal healing trajectory¹¹.

Benefits and Results

DEBRICHEM is a single-use medical device with a contact time of only 60 seconds. With over 90% of cases requiring just one application, this procedure does not require specialist certification and can be applied in any healthcare setting by a healthcare professional¹¹.

A UK study on venous leg ulcer management compared DEBRICHEM plus standard of care (SOC) to SOC alone and found:

• 75% increase in the probability of healing
• 59% reduction in nursing and healthcare assistant visits
• >90% reduction in hospital admissions and emergency visits
• overall, 57% reduction in total NHS wound management costs
   

Most importantly, improvements in patient quality of life were also observed¹⁰.

Ready to Embrace Innovation in Wound Care?

DEBRICHEM presents a unique opportunity to address the challenges of treating chronic wounds in Australia.

With adherence to the principle that wound care should be provided at the lowest appropriate cost without compromising best practice¹², a challenge is then presented to the economic modelling of delivering wound care. A holistic approach is needed, looking at and factoring in the total cost of treating chronic wounds. With ever-increasing demand for healthcare and limited public money to fund it, healthcare managers require evidence of clinical cost-effectiveness to inform their decision making¹⁰.

Considering costs such as hospitalisation and nursing time, solutions such as DEBRICHEM have been proven internationally to reduce the total cost of treating chronic wounds¹⁰.

Finally, remembering the patient’s experience is crucial and the most valuable. Living with a chronic wound can be painful and debilitating. Providing an effective treatment that can support healing, reducing costly and repetitive healthcare visits, and improving the patient’s quality of life would certainly be the main goal of all those involved in wound care.

Talk to the team at Gaia Medical about how DEBRICHEM can support your wound care practice. Find out more at https://gaiamedical.com.au/debrichem/?utm_source=hospital%2Bhealthcare&utm_medium=enewscontent

Always consult the IFU for indications and contraindications.

Disclosure: Gaia Medical is the sole distributor of DEBRICHEM in Australia.

1. Wounds Australia. (2024). 5 Point Plan to solve Australia’s Chronic Wound Epidemic.
2. Graves, N & Zheng, H (2014). Modelling the direct health care costs of chronic wounds in Australia. Wounds Practice and Research.
3. NSW Health. (2021). Chronic wound management. https://www.health.nsw.gov.au/Value/lbvc/Pages/wounds.aspx#:~:text=Wounds%20can%20result%20in%20long,after%20partial%20or%20complete%20healing
4. Lindholm C, Searle R. Wound management for the 21st century: combining effectiveness and efficiency. Int Wound J. 2016 Jul;13 Suppl 2(Suppl 2):5-15. doi: 10.1111/iwj.12623. PMID: 27460943; PMCID: PMC7949725.
5. Guest JF, Fuller GW, Vowden P. Cohort study evaluating the burden of wounds to the UK’s National Health Service in 2017/2018: update from 2012/2013. BMJ Open 2020;10:e045253. doi: 10.1136/bmjopen-2020-045253
6. Edwards H, Kathleen K, Maresco-Pennisi D, et al. (2014). The long and winding road: health services for clients with chronic leg ulcers in the community. Wound Practice and Research. Cambridge Media.
7. Queensland Health. (2023) Chronic wound assessment & management. https://www.health.qld.gov.au/__data/assets/pdf_file/0030/1243785/48.Chronic-wound-assessment-and-management.pdf
8. Malone M, Bjarnsholt T, McBain AJ, et al. (2017). The prevalence of biofilms in chronic wounds: a systematic review and meta-analysis of published data. J Wound Care. 2017 Jan 2;26(1):20-25. doi: 10.12968/jowc.2017.26.1.20. PMID: 28103163.
9. Mayer D , Tettelbach W, Ciprandi G, et al. Best practice for wound debridement. Journal of Wound Care 2024 33:Sup6b, S1-S32
10. Guest JF, Deanesi V, and Segalla (2022). Cost-effectiveness of Debrichem in managing hard-to-heal venous leg ulcers in the UK. J Wound Care. Medpharm Publications. doi: 10.12968/jowc.2022.31.6.480
11. DebX Medical. https://www.debx-medical.com/
12. Wounds International (2017). International consensus: Making the case for cost-effective wound management wounds international. https://woundsinternational.com/consensus-documents/international-consensus-making-case-cost-effective-wound-management/

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