Learning Objectives

Upon completion of this Journal Club the participant will be able to:
1. Identify best practices for treatment of pressure ulcers.
2. Describe two challenges in meeting evidence-based recommendations for wound care treatment.
3. Discuss one goal for symptom management of wounds in chronic wound patients

Background Information

Cost estimates for wound care treatment varies widely according to the type of wound and treatment setting. The cost for pressure ulcer care is estimated at over $1.4 billion per year. The cost to heal a leg ulcer is estimated at about $2,000 and the cost for a diabetic foot ulcer is upwards of $30,000. More than $25 billion is spent each year on wound care and the expense is expected to grow. Identifying and evaluating information on best practices will be essential to maintaining both a high level of quality care and to control costs associated with effective care.

Several guidelines have been developed for the assessment and management of wounds. The purpose of these guidelines is to standardize and improve care while controlling costs. Evidence-based guidelines have recommendations that are graded according to how well the evidence supports their successful use. However, many recommendations don’t have support from strong controlled trials and are developed from expert opinion based on experience. Research is needed to demonstrate the appropriateness and effectiveness of recommendations in guidelines.

In September 2007, a description of the process to develop evidence based recommendations and algorithms were published.[1] A series of guidelines were published in 2006 for the treatment of several types of wounds, including pressure ulcers, diabetic ulcers, arterial insufficiency ulcers, and venous ulcers.[2] [3] [4] [5]Guidelines have been used to improve identification, treatment, and cost containment in caring for patients.[6] Evidence-based guidelines provide a way to plan for such positive outcomes. Guidelines generally review the evidence to support procedures for the identification and treatment review cost issues of the alternative therapies.