The American Journal of Surgery
Volume 195, Issue 6 , Pages 782-788 , June 2008

Resource utilization and economic costs of care based on a randomized trial of vacuum-assisted closure therapy in the treatment of diabetic foot wounds

  • Jan Apelqvist, M.D., Ph.D.

      Affiliations

    • Department of Endocrinology, University Hospital of Malmö, Malmö, Sweden
    • Division for Clinical Sciences University of Lund, Lund, Sweden
    • ,
  • David G. Armstrong, D.P.M., Ph.D.

      Affiliations

    • Scholl's Center for Lower Extremity Ambulatory Research (CLEAR) at Rosalind Franklin University of Medicine and Science, 3333 Green Bay Rd., Chicago, IL, 60064, USA
    • Corresponding Author InformationCorresponding author. Tel.: +1-847-578-8440; fax: +1-847-557-1457.
    • ,
  • Lawrence A. Lavery, D.P.M., M.P.H.

      Affiliations

    • Department of Surgery, Scott and White Hospital, Texas A&M University Health Science Center College of Medicine, Temple, TX, USA
    • ,
  • Andrew J.M. Boulton, M.D., F.R.C.P

      Affiliations

    • University Department of Medicine, Manchester Royal Infirmary, Manchester, United Kingdom
    • University of Miami, Miami, FL, USA

Received 4 June 2007 ,Revised 22 June 2007

References 

  1. Ramsey SD, Newton K, Blough D, et al. Incidence, outcomes, and cost of foot ulcers in patients with diabetes. Diabetes Care. 1999;22:382–387
  2. Ragnarson Tennvall G, Apelqvist J. Health-economic consequences of diabetic foot lesions. Clin Infect Dis. 2004;39(suppl 2):S132–S139
  3. Armstrong DG, Lavery LA, Harkless LB. Validation of a diabetic wound classification system: the contribution of depth, infection, and vascular disease to the risk of amputation. Diabetes Care. 1998;21:8559
  4. Apelqvist J. Wound healing in diabetes (Outcome and costs). Clin Podiatr Med Surg. 1998;15:21–39
  5. Apelqvist J, Ragnarson-Tennval G, Persson U, et al. Diabetic foot ulcers in a multidisciplinary setting- an economic analysis of primary healing and healing with amputation. J Intern Med. 1994;235:463–471
  6. Tennvall GR, Apelqvist J, Eneroth M. Costs of deep foot infections in patients with diabetes mellitus. Pharmacoeconomics. 2000;18:225–238
  7. Ragnarson Tennvall G, Apelqvist J. Health-related quality of life in patients with diabetes mellitus and foot ulcers. J Diabetes Complications. 2000;14:235–241
  8. Boulton AJ, Vileikyte L, Ragnarson-Tennvall G, et al. The global burden of diabetic foot disease. Lancet. 2005;366:1719–1724
  9. Ghatnekar O, Persson U, Willis M, et al. Cost effectiveness of becaplermin in the treatment of diabetic foot ulcers in four european countries. Pharmacoeconomics. 2001;19:767–778
  10. Ghatnekar O, Willis M, Persson U. Cost-effectiveness of treating deep diabetic foot ulcers with promogran in four european countries. J Wound Care. 2002;11:70–74
  11. Redekop WK, McDonnell J, Verboom P, et al. The cost effectiveness of Apligraf treatment of diabetic foot ulcers. Pharmacoeconomics. 2003;21:1171–1183
  12. Allenet B, Paree F, Possnett J, et al. Cost-effectiveness of Dermagraftr for the treatment of diabetic foot ulcers in France. Diabetologia. 1999;42(suppl 1):A308
  13. Persson U, Willis M, Odegaard K, et al. The cost-effectiveness of treating diabetic lower extremity ulcers with becaplermin (Regranex): a core model with an application using Swedish cost data. Value Health. 2000;3(suppl 1):39–46
  14. Treweek S, James PB. A cost analysis of monoplace hyperbaric oxygen therapy with and without recirculation. J Wound Care. 2006;15:235–238
  15. Armstrong DG, Lavery LA. Negative pressure wound after partial diabetic foot amputation: a multicentre, randomised controlled trial. Lancet. 2005;366:1704–1710
  16. Armstrong DG, Attinger CE, Boulton AJ, et al. Guidelines regarding negative wound therapy (NPWT) in the diabetic foot. Ostomy Wound Manage. 2004;50(suppl 4B):3S–27S
  17. Sibbald RG, Mahoney J. A consensus report on the use of vacuum-assisted closure in chronic, difficult-to-heal wounds. Ostomy Wound Manage. 2003;49:52–66
  18. Joseph E, Hamori CA, Bergman S, et al. A prospective randomized trial of vacuum-assisted closure versus standard therapy of chronic nonhealing wounds. Wounds. 2002;12:60–67
  19. McCallon SK, Knight CA, Valiulus JP, et al. Vacuum-assisted closure versus saline-moistened gauze in the healing of postoperative diabetic foot wounds. Ostomy Wound Manage. 2000;46:282
  20. Moues CM, van den Bemd GJ, Meerding WJ, et al. An economic evaluation of the use of TNP on full-thickness wounds. J Wound Care. 2005;14:224–227
  21. Braakenburg A, Obdeijn MC, Feitz R, et al. The clinical efficacy and cost effectiveness of the vacuum-assisted closure technique in the management of acute and chronic wounds: a randomized controlled trial. Plast Reconstr Surg. 2006;118:390–397
  22. Wound Ostomy Continence Nursing Society. Guideline for Management of Wounds in Patients With Lower-Extremity Neuropathic Disease. In: Glenview, IL: WOCN; 2004;p. 57
  23. Armstrong DG, Attinger CE, Boulton AJM, et al. Guidelines regarding negative pressure wound therapy in the diabetic foot: results of the Tucson Expert Consensus Conference. Ostomy Wound Manage. 2004;50(suppl 4B):3S–27S
  24. Armstrong DG, Lavery LA, Abu-Rumman P, et al. Outcomes of subatmospheric pressure dressing therapy on wounds of the diabetic foot. Ostomy Wound Manage. 2002;48:64–68
  25. Hersh RE, Jack JM, Dahman MI, et al. The vacuum-assisted closure device as a bridge to sternal wound closure. Ann Plast Surg. 2001;46:250–254

 Financial support for this study was provided by KCI, San Antonio, TX.

PII: S0002-9610(08)00006-8

doi: 10.1016/j.amjsurg.2007.06.023

The American Journal of Surgery
Volume 195, Issue 6 , Pages 782-788 , June 2008

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