CHRONIC WOUNDS AS A SOCIOECONOMIC BURDEN

Authors

  • Stoyan Bogoev Department of Vascular surgery & Angiology - UMHAT “St. George”, Bulgaria

Keywords:

Chronic wounds, diabetic foot, therapeutic algorithm, healthcare budget

Abstract

Chronic wounds compel a significant burden to the patients, healthcare providers, and the healthcare system. They can be classified as typical and atypical. The majority of wounds (95%) are typical ones, which include ischemic, neurotrophic and hypostatic ulcers and two separate entities: diabetic foot and decubital ulcers. Lower extremity ulcer is most common in our population due to their chronicity. Eighty percent of chronic wounds localized on lower leg are the result of chronic venous insufficiency, in 5-10 percent the cause is of arterial etiology, whereas the rest are mostly neuropathic ulcers. Chronic wounds significantly decrease the quality of life of patients by requiring continuous topical treatment, causing immobility and pain in a high percentage of patients, the majority of which are the elderly. Leg ulcers affect 0.6-3 percent of those aged over 60, increasing to over 5 percent of those aged over 80. The occurrence of difficult-to-heal wounds is a significant socio-economic problem, as 1-2% of the western population suffers from them. This percentage is expected to increase, on the one hand due to an increase in the elderly population, on the other hand - an increase in the incidence of diabetes and obesity. Chronic wounds have been shown to be a significant expense in the healthcare system, even in developed countries. Socio-economically, dealing with this type of wound is equal to 2-4% of the health budget of Western countries. It is considered that this percentage is significantly higher for the countries of the Balkan Peninsula, but at the moment there are no accurate statistics on this, partly due to the lack of a national unified statistical system and the neglect of this problem as from health professionals working outside the major university centers, as well as from the patients themselves, who do not seek medical help as soon as and ulcer appears. A statistical analysis of the non-medical status of 170 patients showed that mostly people suffering from chronic wounds have a low level of education, low income, living in places separated from large medical centers.

Numerous conventional wound-healing modalities have been evaluated in the management of non- healing wounds, but a multifaceted approach is lacking. In addition the lack of a unified algorithm for treatment and standartised forms for the gathering of data further perplex this complicated problem.

The right approach to wound management should consider how to reduce the economic burden while lowering morbidity and mortality. Developing new preventive and therapeutic technologies will have significant results, especially in low- and middle-income countries (LMICs) where affordability and accessibility to quality healthcare is a challenge

The use of the right therapeutic algorithm, a holistic approach to wound assessment, a multidisciplinary team and methods to increase patient awareness of this particular issue ensure the optimal treatment of chronic wounds with minimal expense to the patient and the healthcare system.

References

Чешмеджиева, Б. (2020). Ролята на хибридната хирургия при лечението на периферната артериална болест. Медицински и социални аспекти.: стр. 68 – Анализ на резултатите от изследванията.

Bowers, S., & Franco, E. (2020). Chronic wounds: evaluation and management. Am Fam Physician 101(3):159–66

Collier, M. (2004). Recognition and management of wound infections. World Wide Wounds 7:8–14

Fletcher, J., & Barrett, S. (2018). Improving holistic assessment of chronic wounds: how to meet patient expectation using the new Best Practice Statement. Wounds UK 14(5):92–5. https://tinyurl.com/ya898mta (accessed 17 November 2020)

Gajjam Shrinivas, A., & Amol, W. (2017). [ To evaluate lower extremity ulcer cases in respect of their aetiological basis] . International Surgery Journal , Vol 4, Issue 3

Kapp, S., & Santamaria, N. (2017). The financial and quality‐of‐life cost to patients living with a chronic wound in the community. Int Wound J 14(6):1108–19. https://doi.org/10.1111/iwj.12767

Mheshwari, G., Gupta, S., Tripathi, S., & Sagar, S. (2021). [Chronic Wounds : magnitude, socioeconomic burden and consequences]. Wounds Asia 2021, Vol 4 ,Issue 1

Rutherford’s vascular surgery and endovascular therapy; 9th edition ( 2018 ): Chapter 113 General Considerations of Diabetic Foot Ulcers.

Situm, M., Kolić, M., Redzepi, G., & Antolić, S. (2014). [Chronic wounds as a public health problem] . Acta Med Croatica. 2014 Oct;68 Suppl 1:5-7

Wound care made incredibly easy (2009) 1st edition: Chapter 2 Wound assessment and monitoring.

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Published

2021-12-15

How to Cite

Bogoev, S. (2021). CHRONIC WOUNDS AS A SOCIOECONOMIC BURDEN. KNOWLEDGE - International Journal , 49(4), 885–888. Retrieved from https://ikm.mk/ojs/index.php/kij/article/view/4573