Dehydrated human amnion/chorion membrane to treat venous leg ulcers: a cost-effectiveness analysis

Journal of Wound Care, Journal Year: 2024, Volume and Issue: 33(Sup3), P. S24 - S38

Published: March 1, 2024

Objective: To evaluate the cost-effectiveness of dehydrated human amnion/chorion membrane (DHACM) in Medicare enrolees who developed a venous leg ulcer (VLU). Method: This economic evaluation used four-state Markov model to simulate disease progression VLUs for patients receiving advanced treatment (AT) with DHACM or no (NAT) over three-year time horizon from US perspective. treatments were assessed when following parameters use (FPFU), whereby applications initiated 30–45 days after initial VLU diagnosis claim, and reapplications occurred on weekly biweekly basis until completion episode. The cohort was modelled claims 530,220 between 2015–2019. Direct medical costs, quality-adjusted life years (QALYs), net monetary benefit (NMB) at willingness-to-pay threshold $100,000/QALY applied. Univariate probabilistic sensitivity analyses (PSA) performed test uncertainty results. Results: applied FPFU dominated NAT, yielding lower per-patient cost $170 an increase 0.010 QALYs three years. resulting NMB $1178 per patient favour same horizon. rate recurrence had notable impact uncertainty. In PSA, cost-effective 63.01% simulations threshold. Conclusion: this analysis, dominant strategy compared as it cost-saving generated greater number A companion outcomes analysis revealed that received AT cellular, acellular matrix-like product (CAMP) NAT best outcomes. Given added clinical benefits cost, providers should recommend qualify. Decision-makers public insurers (e.g., Medicaid) commercial payers establish preferential formulary placement reimbursement reduce budget improve long-term health their populations dealing these chronic wounds. Declaration interest: Support provided by MiMedx Group, Inc., US. JLD, RAF are employees Inc. WHT, BH, PS, BGC WVP consultants VD, AO, MRK, JAN, NW GAM served Advisory Board. MRK JAN speaker's bureau. declares personal fees equity holdings Stage Analytics,

Language: Английский

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Skin Grafting for Dermatologists: Past, Present, and Future

Current Dermatology Reports, Journal Year: 2024, Volume and Issue: 13(2), P. 47 - 54

Published: April 9, 2024

Abstract Purpose of This Review Skin grafting is a surgical procedure that involves replacing damaged or missing skin with healthy skin. technique helps protect wounds, promotes healing, and enhances functionality appearance. can be beneficial in treating burns, traumatic injuries, chronic ulcers, congenital defects, among others. Recent Findings A range cellular tissue-based products (CTPs) employed, either conjunction autologous grafts independently, to facilitate wound healing. Human allografts, sourced from donated human skin, often obtained cadavers, serve as valuable resource for protection. Allogeneic matrices, comprising neonatal fibroblasts membranes, alongside chorion, amnion, other placental products, provide means accelerate the healing process. Composite which combine keratinocytes, fibroblasts, xenogeneic collagen, solution replicate complexity natural Moreover, acellular matrices derived collagen tissue offer versatile platform regeneration. Conclusion complex requires careful planning postoperative care. Success depends on factors like type graft, management, overall health patient. has evolved advancements surgery, anesthesia, care remains crucial restoring function

Language: Английский

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A clinician survey of skin substitute use in burns in the UK and Ireland: the CASSIUS study

Journal of Plastic Reconstructive & Aesthetic Surgery, Journal Year: 2025, Volume and Issue: unknown

Published: Jan. 1, 2025

Language: Английский

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Comparative Study of Placental Allografts with Distinct Layer Composition

International Journal of Molecular Sciences, Journal Year: 2025, Volume and Issue: 26(7), P. 3406 - 3406

Published: April 5, 2025

Human placental-derived allografts are biomaterials categorized as cellular, acellular, matrix-like products (CAMPs) that can serve wound coverings due to placenta tissue's innate barrier function. The placental membrane consists of three layers, the amnion, intermediate layer (IL), and chorion, each contributing distinct functional biological properties. This study investigates how variations in composition influence Extracellular Matrix (ECM) growth factor profiles allografts. We compared Dual Layer (amnion-amnion), Full Thickness (amnion-intermediate-chorion, FT), a novel four-layer allograft configuration (amnion-intermediate-chorion-amnion, ACA). Histological analyses using hematoxylin eosin (H&E) Masson's trichrome staining revealed structural architecture among allografts, with FT ACA exhibiting 4.9 times 5.7 greater thickness Layer, respectively. Compositional studies different concentrations key ECM components (collagen, elastin, proteoglycans, hyaluronic acid) factors (ANG-2, EGF, PDGF-AA, VEGF) across collagen concentration was two higher FT. Additionally, demonstrated levels other components, underscoring their biochemical diversity. These findings highlight fact properties depend on composition. underscores importance tailoring configurations optimized for clinical applications CAMPs, enabling clinicians select most suitable grafts use, such management.

Language: Английский

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Clinical Efficacy of Ovine Forestomach Matrix and Collagen/Oxidised Regenerated Cellulose for the Treatment of Venous Leg Ulcers: A Retrospective Comparative Real‐World Evidence Study

International Wound Journal, Journal Year: 2025, Volume and Issue: 22(4)

Published: April 1, 2025

ABSTRACT Venous leg ulcers (VLUs) are traditionally managed with standard‐of‐care dressings, compression and appropriate adjunctive venous interventions for pathologic reflux. Due to pathophysiological complexity underlying patient comorbidities, conducting randomised controlled trials evaluate the comparative efficacy of advanced treatment modalities is difficult, as many patients would likely be excluded. This retrospective, pragmatic, real‐world evidence (RWE) study compared healing outcomes VLUs treated either ovine forestomach matrix (OFM) ( n = 312) or collagen/oxidised regenerated cellulose (ORC) 239) in outpatient wound care centres. Unlike restrictive trials, minimal inclusion exclusion criteria were applied create two cohorts that reflected general VLU population. The incidence (%) closure was greater OFM‐treated at 12, 24 36 weeks, this difference significant weeks collagen/ORC. Median time significantly faster p 0.045) OFM cohort (11.1 ± 0.6 weeks) collagen/ORC group (12.3 1.0 weeks). Cox proportional hazards analysis demonstrated had a probability (up ~40%). RWE further substantiates clinical benefit chronic wounds, such VLU, cohort.

Language: Английский

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Use of Topical Oxygen Therapy in Wound Healing

Journal of Wound Care, Journal Year: 2023, Volume and Issue: 32(Sup8b), P. S1 - S32

Published: Aug. 1, 2023

Language: Английский

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Treatment patterns and outcomes of Medicare enrolees who developed venous leg ulcers

Journal of Wound Care, Journal Year: 2023, Volume and Issue: 32(11), P. 704 - 718

Published: Nov. 1, 2023

To retrospectively evaluate the comorbidities, treatment patterns and outcomes of Medicare enrolees who developed venous leg ulcers (VLUs).Medicare Limited Data Standard Analytic Hospital Inpatient Outpatient Department Files were used to follow patients received medical care for a VLU between 1 October 2015 2 2019. Patients diagnosed with chronic insufficiency (CVI) propensity matched into four groups based on their regimen. Episode claims document demographics, comorbidities treatments VLUs, as well important outcomes, such time ulcer closure, rates complications hospital utilisation rates. Outcomes compared across key propensity-matched groups.In total, 42% CVI (n=1,225,278), at least one during study, 79% had episode claim completed within year. However, 59% another study period. This analysis shows that only 38.4% episodes documented conservative treatment. Propensity-matched an advanced or high-cost skin substitutes wound which not progressed by 30 days demonstrated best when cellular, acellular, matrix-like product (CAMP) was applied weekly biweekly (following parameters use). Complications infection (33%) emergency department visits (>50%) decreased among use).Medicare have diverse many do receive sufficient management, contributes high VLUs subsequent complications. risk early identification CAMP improved quality life significantly reduced healthcare resource utilisation.

Language: Английский

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A review of the proposed draft CAMPs LCDs compared to evidence-based medicine: a letter to the MACs for consideration

Journal of Wound Care, Journal Year: 2024, Volume and Issue: 33(Sup7), P. S16 - S23

Published: June 7, 2024

Language: Английский

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Cost effectiveness analysis for commonly used human cell and tissue products in the management of diabetic foot ulcers

Health Science Reports, Journal Year: 2024, Volume and Issue: 7(3)

Published: March 1, 2024

This study considers the cost-effectiveness of commonly used cellular, acellular, and matrix‑like products (CAMPs) human origin also known as cell tissue (HCT/Ps) in management diabetic foot ulcers.

Language: Английский

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Assessing placental membrane treatment efficiency in diabetic foot ulcers: Processing for retention versus lamination

Health Science Reports, Journal Year: 2024, Volume and Issue: 7(6)

Published: June 1, 2024

Abstract Background Diabetic foot ulcers are a severe complication in diabetic patients, significantly impact healthcare systems and patient quality of life, often leading to hospitalization amputation. Traditional Standard Care (SOC) treatments inadequate for many necessitating advanced wound care products (AWCPs) like human placental membranes. This study conducts retrospective analysis compare the effectiveness two membrane products, retention‐processed amnion chorion (RE‐AC) lamination‐processed (L‐AC) managing chronic (DFUs). Methods The collected observational data from electronic health records (EHRs) patients treated DFU at three outpatient centers. Patients were categorized into cohorts based on treatment received. Key metrics included size progression number product applications. employed Bayesian estimation, utilizing an covariance model with Hurdle Gamma likelihood. Results We found that RE‐AC achieved marginally higher expected Percent Area Reduction (xPAR) DFUs compared L‐AC 12 weeks (67.3% vs. 52.6%). also required fewer applications, suggesting greater efficiency general closure. Probability full closure was similar both groups (0.738 vs 0.740 L‐AC, respectively). Conclusion findings suggest while might be slightly more effective complete ulcer healing, offers overall better efficiency, especially reducing frequency can lead improved comfort, reduced costs, optimized resource utilization settings.

Language: Английский

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