From the Guidelines
Paid non-healing wound treatments should prioritize advanced therapies like negative pressure wound therapy (NPWT) or hyperbaric oxygen therapy (HBOT) after 4 weeks of standard care, as these options have shown effectiveness in promoting healing and improving quality of life, as supported by recent guidelines 1.
Key Considerations
- Advanced wound therapy should be considered if a wound fails to show a reduction of 50% or more after 4 weeks of appropriate wound management, including offloading, debridement, revascularization, infection management, and use of physiologic topical dressings 1.
- Negative pressure wound therapy (NPWT) is a viable option, with costs ranging from $100-200 per day, and has been shown to promote healing in chronic wounds 1.
- Hyperbaric oxygen therapy (HBOT) is another option, with costs ranging from $250-450 per session, and may be beneficial for wound healing, although its effectiveness is still being researched 1.
- Topical treatments, such as collagen dressings, growth factor gels, and advanced moisture-retaining dressings, can also be effective in promoting wound healing, with costs varying depending on the specific treatment 1.
Important Factors
- Proper wound assessment by a healthcare professional is crucial to identify specific barriers to healing and determine the most cost-effective approach 1.
- Regular debridement of dead tissue and management of underlying conditions, such as diabetes or vascular disease, are essential for successful outcomes, regardless of the chosen treatment 1.
- Advanced wound therapy should be managed in an interprofessional setting to ensure comprehensive care and optimal outcomes 1.
From the Research
Paid Non-Healing Wound Treatment
- Non-healing wounds, including pressure, diabetic, and venous ulcers, can be treated with various techniques, such as platelet-rich plasma, hydrogel, hyperbaric oxygenation, and integrated care 2, 3.
- The efficacy of these treatments can vary, and some wounds may respond more slowly or poorly to treatment, while others may be recalcitrant to treatments 2.
- Negative pressure wound therapy (NPWT) is a treatment that promotes healing by evenly applying negative pressure on the surface of the wound, and has been shown to be effective in managing diabetic foot ulcers, pressure ulcerations, chronic wounds, and skin grafts 4, 5.
- The mechanism of action of NPWT involves macrodeformation of the tissues, drainage of extracellular inflammatory fluids, stabilization of the environment of the wound, and microdeformation, and has been shown to upregulate the expression of certain RNA-binding proteins, such as FUS and ILF2, which promote wound healing by regulating the function of keratinocytes and reducing the inflammatory response and oxidative stress 5.
- Debridement, the removal of dead or unhealthy tissue from a wound, is also an important component of wound management, and can be performed using various methods, including surgical, autolytic, and enzymatic debridement 6.
- The choice of treatment for non-healing wounds should be based on the individual patient's needs and preferences, as well as the wound's characteristics and the physician's experience, and should take into account the costs and potential benefits of each treatment option 3.