Technology update The role of ALLEVYNTM


Ag in the management of hard-to-heal wounds


1.0 0.9 0.8 0.7 0.6 0.5 0.4 0.3 0.2 0.1 0.0


References


47. White RJ, Cooper RA. Silver sulphadiazine. Wounds UK 2005; 1: 51–61.


0 10 20 30 40 Figure 3 – Kaplan-Meier plot of time-to-closure. This study provides benchmark data that


may support a structured treatment protocol with frequent debridement, together with weekly dressing changes using ALLEVYN Ag in infected, hard-to-heal venous leg ulcers[54]


.


Cost-effectiveness of ALLEVYN Ag A cost comparison model [Table 1] comparing the wound closure rates achieved by Lantis and Gendics[54]


and standard care has subsequently


been extrapolated. This table makes a number of assumptions in relation to wound closure rates and frequency of dressing changes in the standard care arm. Furthermore, it assumes that, once the wound is closed, these patients do not incur any further costs and does not factor in follow-on costs associated with further clinic attendance by patients in either


arm using standard care versus ALLEVYN Ag. For the purposes of this cost-comparison model, the study by Skog et al [35]


to provide a control baseline, as there was no standard care arm in the study by Lantis and Gendics [54] et al[35]


50 60 Time (days) 70


48. Buckley SC, Scott S, Das K. Late review of the use of silver sulphadiazine dressings for the treatment of fingertip injuries. Injury 2000; 31(5):301–4.


has been used


. The closure rate achieved by Skog was 3%. To provide a more conservative


measure, a 5% wound closure rate for standard care in hard-to-heal venous leg ulcers is assumed in the model. The dressing change frequency in the study by Lantis and Gendics was every 7.2 days[54]


. When calculating costs for the standard


care arm, twice-weekly dressing changes have been assumed to reflect standard clinical practice in such wounds[16]


, with an average of 32 minutes


nursing time per visit. Using these assumptions, it is possible to model the costs of once-weekly versus


49. Bishop JB, Phillips LG, Mustoe TA, et al. A prospective randomized evaluator–blinded trial of two potential wound healing agents for the treatment of venous stasis ulcers. J Vasc Surg 1992; 1 6(2): 251–57.


50. Ulkür E, Oncül O, Karagöz H, et al. Comparison of silver–coated dressing (Acticoat™), chlorehexidine acetate 0.5% (Bactigras®) and silver sulfadiazine 1% (Silverdin®) for topical antibacterial effect in Pseudomonas aeruginosa contaminated full–thickness burn wounds in rats. J Burn Care Rehabil 2005; 26(5): 430–3.


51. Smith & Nephew. Report reference DS/08/116/R1f. Carpenter S. Silver release of ALLEVYN dressings, June 2009.


52. Smith & Nephew. Data on file report 1011017.


53. Smith & Nephew. Data on file report 1011018.


Parameters Treatment length (days


Mean time to wound closure (days)


Wear time (days)


Duration of community nurse visit (minutes)


Wound closure rate


Compression + ALLEVYNTM


Ag 84 (12 weeks) 57.3 (eight weeks) 7.2 30 (US$47/hour) 45.8% Table 1 – Cost comparison of ALLEVYNTM


Compression only (standard care)


84 (12 weeks) 57.3 (eight weeks) 3.5 30 (US$47/hour) 5% Ag plus compression versus standard care. Source


Lantis and Gendics[54] Lantis and Gendics[54]


Lantis and Gendics [54] Tennvall et al[16]


US Bureau of Labor Statistics


Lantis and Gendics[54] Skog et al[35]


54. Lantis JC, Gendics C. In vivo effect of sustained–release silver sulphadiazine foam on bioburden and wound closure in infected venous leg ulcers. J Wound Care 2011; 20(2): 90–6.


55. Falanga V, Margolis D, Alvarez A et al. Rapid healing of venous ulcers and lack of clinical rejection with an allograft cultured human skin equivalent. Arch Dermatol 1998; 134: 293–99.


56. McKeown T, Hoctor B. Meeting the challenges of a nurse–led dressing clinic in a busy A&E. Enhancing Clinical Practice 2009; 4–7.


www.woundsinternational.com


34


Technology and product reviews


Probability of closure


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