A guide to cost-effective management of leg ulcers

Abstract

Chronic wounds have a substantial economic impact on the NHS, with leg ulcers alone costing almost £4.6 billion per year. Approximately 2% of the adult population is affected by lower limb ulceration, and this is rising as a result of demographics, including longer life expectancy and the increasing prevalence of obesity and diabetes. Even after healing, the recurrence rate of leg ulcers is high, meaning that the cost and health impact is a long-term problem. There appears to be a large variation in treatment methods, possibly as a result of a lack of evidence-based practices. The variation in practice means that, in many areas, healing times are far from optimal, leading to increased costs and health burden for the patient. This article outlines a number of previously published recommendations, including the leg ulcer treatment pathway. The article also provides an overview of the considerations when undertaking an economic evaluation of pathways, and provides recommendations about the type of data that should be routinely collected in clinical trials.