The Little-Known, Silent Epidemic of Non-Healing Wounds
Patient Safety Many are unaware they are at high risk for non-healing wounds, which, if left untreated, can lead to infections with hospitalization, amputation and death.
An estimated prevalence rate for chronic, non-healing wounds in the United States is 2 percent of the general population. The staggering cost of managing these patients’ wounds exceeds $50 billion per year. This is 10 times more than the annual budget of the World Health Organization. The prevalence of chronic wounds is thought to be comparable to heart failure. However, unlike heart failure, little is known about the value of the treatments administered, or the outcome of these patients.
Wound healing physicians and researchers have discovered who is at risk for a serious wound complication, but this relatively new field is struggling to develop advanced therapies that adequately treat this disease process. Furthermore, different diseases have different types of non-healing wounds that respond uniquely to treatments.
For example, the number of diabetics globally is expected to be greater than 500 million by the year 2035. Being diabetic carries with it a 25 percent lifetime risk of developing a high-risk chronic wound with recurrence rates within five years being 50–70 percent. We also know that not only are bedridden or wheelchair-dependent individuals at risk for high-risk wounds, caused by pressure, sometimes called bedsores, so are patients recovering from surgery or those with conditions like nerve damage, heart failure and kidney disease.
One of the most common wounds found on the leg are painful venous leg ulcers, found in patients with blood flow problems. All of these types of wound can be hard to heal and this is what makes them more prone to infection, which can lead to hospitalization or amputation, even death. Caring for patients with these high-risk wounds can be challenging. Early intervention is important often to improve blood flow or to stop and infection from spreading as an important initial step. The likelihood of a successful outcome is greatly increased if a patient is seen at an experienced wound clinic early.
One of the major hurdles in treating patients with high-risk wounds is the lack of effective therapies. The pathway for development of therapies is cumbersome because wounds cross over many disease states (diabetes, kidney disease, inflammatory diseases) and this complicates the understanding of the science. Another issue that stymies development of new therapies is that wound healing has multiple phases and patients frequently have complicated diseases, so it is a complex treatment process that is often required—not a quick fix.
Therefore, in developing therapies it isn’t likely that any one drug or device will provide what is needed at every stage of wound healing. Because of this we are seeing initiatives joining experts together with the Food and Drug Administration to identify new patient-related measures that can be used in the development of new therapies. This will encourage new development of novel therapies to treat issues found throughout the continuum of care of the patient and during the entire process required to heal many wounds.
While hard to heal wounds can be devastating for patients, especially if not treated early, the good news is that a wound care specialist with a medical team can make headway, even when the odds of success are low. If you or your loved one has a chronic wound, reach out to find a specialist.
On Diabetic Foot Ulcers
The cost of diabetic foot ulcers is greater than that of the five most costly forms of cancer
Diabetic Foot Ulcer patients are twice as costly to U.S. Medicare as those with diabetes alone
The estimated annual U.S. Burden of Diabetic Foot Ulcers is at least $15 Billion
Within one year of wound healing following ulceration, up to 60 percent of patients with a positive ulceration history will develop another
If diabetic ulcers fail to heal and progress into deep infection or gangrene, amputation of the lower extremity may ensue, resulting in a 6–22 percent cumulative amputation rate for patients with an ulcer
More than 60 percent of non-traumatic lower limb amputations occur in diabetic individuals, and at least 80 percent of amputations are preceded by an ulcer
This disease deserves a voice to help stand up for all of the patients that are afflicted by this devastating problem, then maybe we can find real change
Extensive patient education, early assessment, and aggressive treatment by a multidisciplinary team represent the best approach to manage high-risk patients with diabetes and wounds