Biomedical Engineering Reference
In-Depth Information
Table 2.1
Patients needing advanced wound care
Wounds requiring advanced care
Number of patients affected
Pressure ulcer
200 000
Venous ulcer
300 000
Diabetic foot ulcer
400 000-1 000 000
Burns
40 000
Amputations
100 000-200 000
Trauma
500 000
priority by refusing payment for ulcers that develop during in-patient hospitaliza-
tion. Data on prevalence and incidence of pressure ulcers vary widely, depending
on the population studied. It is estimated that pressure ulcers will affect between 5
and 9% of hospitalized patients and over 14% of the nursing home or acute care
facility population. Stage III and IV ulcers (those that require advanced wound
care) represent 20% of all pressure ulcers.
Certain acute wounds such as amputations, burns and those related to trauma,
infection or surgical wounds require advanced wound care. Over 500 000 patients
require treatment for burns each year in the United States. Over these, 40 000 will
be hospitalized and 4000 will succumb to burn injuries.
10
A search of the National
Center for Health Statistics database revealed over 3 million traumatic wound
admissions each year. It is estimated that 10% of these will require advanced
wound care representing 300 000 wounds. Finally, of the roughly 45 million
surgical procedures performed each year, approximately 5 million are open
procedures and, of these, approximately 5-10% may need advanced wound care.
This would add another 500 000 wounds to the total. When taken together, the
combination of diabetic, venous and pressure ulcers, combined with amputations
and traumatic, surgical and burn wounds, it is estimated that there are over 2
million wounds in the United States alone that will require some type or types of
advanced wound care (Table 2.1).
Over time, some of these numbers will change. The projected increases in the
number of obese, diabetic and elderly patients in the United States will dramati-
cally increase the number of venous, diabetic and pressure ulcers. Better
supplemental restraint systems in automobiles, improved fire and industrial safety
practices and more types of minimally invasive surgery will decrease the numbers
of traumatic, burn and surgical wounds.
2.3 The products
Skin substitutes are engineered dressings designed to facilitate wound closure by
performing as many of the key roles of normal skin as possible. They lack dermal
appendages, an intact microvascular network, immune cells or melanocytes. In
broad terms, the skin substitutes currently available can be grouped into those
