An evaluation of the efficacy and cost-effectivness of octenilin® for chronic wounds

At any one time about 200,000 patients in the UK have a chronic wound, with the most common types of chronic wounds being leg ulcers, pressure ulcers and diabetic foot ulcers (Posnett and Franks, 2007). The cost to the NHS of caring for patients with chronic wounds is estimated to be about £4bn (Sheffield Hallam University, 2014). This cost is predicted to increase over the course of the next 20 years due to an ageing population (Posnett and Franks, 2007). Wound dressings account for about £120m of prescribing costs in primary care in England each year with more than £25m being spent on silver dressings alone (National Prescribing Centre, 2010). The management of chronic wounds places a significant burden on NHS resources and can have a significant detrimental effect on a patient’s life (Briggs and Fleming, 2007). Studies show that there appears to be a high incidence of non-healing wounds in the UK (O’Brien et al, 2002; Moore and Cowan, 2005; Drew et al, 2007). In a study in the East Riding of Yorkshire, involving 1644 patients with a total of 2300 wounds, 24% had their wound for six months or more, and almost 16% of patients had remained unhealed for a year or longer (Drew et al, 2007). In an Irish study involving 389 patients with leg ulcers, 27% were reported to have continuous ulceration for more than two years (O’Brien et al, 2002). Non-healing chronic wounds affect all aspects of patients’ lives — emotionally, mentally, physically and socially. They can also prevent full recovery, increase hospital stays and increase the need for ongoing treatments (Spilsbury et al, 2007). It is critical that wound care is both clinically effective and also cost-effective. Vowden (2011: p5) reported that: ‘effective and timely diagnosis with treatment appropriate to the cause and condition of the wound, alongside active measures to avoid the incidence of wound complications and hospitalisation, can have a major impact on both costs and patient quality of life.’ This article examines the evidence for the clinical efficacy and cost-effectiveness of octenidinebased octenilin® wound gel and octenilin® wound irrigation solution (Schülke & Mayr) in the management of chronic wounds. Two case reports are included looking at atypical patients from an acute hospital setting in the UK. Both patients underwent extensive colorectal surgery and the duration of the acute surgical wounds healing by secondary intention in both cases was protracted with incomplete healing at 12 weeks.