Method in grafting chronic wounds improves healing, reduces cost

Chronic wounds cost the United States' healthcare system $20 billion a year. A team of researchers at the University of Missouri School of Medicine have developed a new skin-graft harvesting system to cut costs and improve patient outcomes.

The harvesting system is minimally invasive, taking only the top layer of skin for smaller donor grafts. The study, published in the National Center for Biotechnology Information, tested the method on diabetic ulcers, venous or lymphedema-related ulcers, surgical site wounds and traumatic wounds. The study included 13 participants with chronic wounds that did not heal. The time to heal and wound center costs were also analyzed in measuring the effectiveness of the method.

"Chronic wounds occur when healing fails to progress normally and persists for more than 30 days," said Jeffrey Litt, assistant professor of surgery at the University of Missouri and lead author of the study. "Current treatments such as moist dressings, frequent irrigations and wound cleaning are not always enough to ensure that healing occurs in high-risk patients. Although a skin graft can be used to close a wound that refuses to heal, the surgical technique usually is painful, time-consuming and leaves significant donor site wounds."

At an improved healing rate of 62 percent, results included:

• Eight of the 13 participants had healed within four months.
• Four had healed in one month.
• Two participants were lost and unable to follow-up.
• Three had wounds that remained open.
• The method saved an average of $1,153 per patient and $650 for the wound center.

“By accelerating wound healing in our patient population, costs associated with subsequent wound care seem to have decreased to a dramatic degree and wound center finances have improved,” concluded Litt and colleagues. “No wound recurrence has been noted once the wounds had healed in our year-long experience with the technology. In addition, the procedure has been well-tolerated and easy to perform. Given the improved outcomes, cost-savings, and a better financial outlook for the wound center, utilization of the novel epidermal autograft harvester is proving itself to be in the “win-win” category of wound care treatments.”

"We have been using this minimally invasive autograft technology for more than a year, and it is well tolerated by our patients and easy to use by our team," said Litt. "Given that, and the healthcare cost savings, we feel that this new approach to wound care is beneficial to everyone, and we will continue to evaluate outcomes."