Table 1.

Concept analysis of cost-effectiveness in wound care1,2,5–8,10–21

Author and year of publication	Type of article	Treatment	Type of wound	Findings	Possible attributes
Anthony6 (2015)	Meta-analysis	NPWT	Various	NPWT requires a shorter treatment duration and fewer dressing changes. NPWT is effective in different settings.	Cost of treatment Safety of treatment Efficiency of treatment Size of wound Duration of treatment
Augustin et al.7 (2016)	Comparative study	Hydroactive dressing containing a nano-oligosaccharide factor versus a neutral foam dressing	Vascular leg ulcers	The hydroactive dressing was more effective in reducing the wound area compared to the neutral foam dressing.	Efficiency of treatment Type of dressing Size of wound
Brown et al.1 (2015)	RCT	Nonpharmacological DITTO intervention versus standard wound care	Paediatric burns	On average, the DITTO intervention resulted in lower direct healthcare costs, direct non-healthcare costs and overall costs per child. Wounds treated with the DITTO intervention re-epithelialised an average of three days faster.	Cost of treatment Efficiency of treatment Type of treatment Rate of wound closure
Browning10 (2014)	Review	Various	Various	The total cost of treatment is dependent on the cost of specialised medical staff and the number of dressing changes required per week. The cost of treatment for infection is dependent on the number of treatments required and the need for surgical debridement.	Cost of treatment Duration of treatment Number of dressing changes Occurrence of complications
Butcher et al.13 (2014)	Review	Various	Chronic wounds	The total cost of care depends on the frequency of interventions and dressing changes and costs associated with staff time and resources. Other costs include disposable items such as dressing packs, pain relief measures, inpatient/outpatient hospital costs and nursing time. Pharmaceutical interventions such as analgaesics and anxiolytic medications also contribute to costs.	Cost of treatment Duration of treatment Number of dressing changes
Carter2 (2014)	Review	Various	Chronic wounds	One study of diabetic foot ulcers demonstrated that IGC in conjunction with optimal foot care was more cost-effective compared to standard care.	Cost of treatment Cost of preventative care
Evans17 (2014)	Review	Various	Various	Soft silicone wound contact dressings have a wide range of wound care applications. Such dressings are more cost-effective in a community setting as one single product can be used for a variety of different types of wounds.	Rate of healing Effectiveness of treatment Versatility of treatment
Gilligan et al.20 (2015)	Retrospective study	Becaplermin gel plus GWC versus GWC alone	Diabetic foot ulcers	Becaplermin gel plus GWC resulted in better outcomes at lower costs compared to GWC alone.	Duration of treatment Rate of wound closure Cost of treatment
Hämmerle et al.11 (2014)	RCT	Octenidine-based wound gel versus modern dressings	Chronic venous leg ulcers	Octenidine gel resulted in a greater reduction in wound size and faster healing rates compared to modern dressings. The overall cost of treatment with octenidine gel was lower.	Cost of treatment Safety of treatment Efficacy of treatment Size of wound Incidence of local infections Rate of healing (granulation tissue and bioburden)
Hampton5 (2015)	Cohort study	NPWT versus standard care	Hard-to-heal leg ulcers or pressure ulcers	The average weekly reduction in wound size was 21% with NPWT. Although the weekly cost of NPWT was expensive, the total cost was lower compared to standard care due to the shortened treatment duration.	Rate of healing Size of wound Cost of treatment Duration of treatment
Jemec et al.19 (2014)	Comparative study	Silver dressings versus non-silver dressings	Hard-to-heal chronic venous leg ulcers.	Patients treated with silver dressings had faster rates of wound closure compared to those treated with non-silver dressings. Silver dressing treatment resulted in a cost-saving of £141.57 compared to non-silver dressings	Rate of healing Cost of treatment
Lima et al.14 (2016)	Descriptive study	Various	Pressure ulcers	Hydrocolloid dressings were the most cost-effective type of dressing.	Rate of healing Type of treatment Cost of treatment Duration of treatment
Maunoury et al.21 (2015)	RCT	Antimicrobial chlorhexidine gluconate-containing securement dressings versus non-antimicrobial transparent dressings	ICU venous/ arterial catheter insertion sites	The chlorhexidine dressing was better in terms of infection prevention compared to the non-antimicrobial dressing.	Cost of treatment Effectiveness of treatment Rate of healing Cost of treatment Duration of treatment Incidence of infection
Othman18 (2012)	Review	NPWT	Chronic wounds	NPWT reduces the cost of chronic wound care management and increases QOL due to faster wound healing rates.	Cost of treatment Duration of treatment Rate of healing
Pham et al.15 (2012)	RCT	4LB versus SSB compression techniques	Venous leg ulcers	Both 4LB and SSB compression techniques were effective and had comparable cost-effectiveness when used by trained registered nurses.	Rate of healing Effectiveness of treatment Cost of treatment Duration of treatment
Sibbald et al.8 (2015)	CME article/validation study	Noncontact infrared skin thermometers	Patients at high risk of developing diabetic foot ulcers	Noncontact infrared skin thermometers were easy to use and available at a considerably lower cost compared to contact infrared thermometers. Due to its ease of use and availability, this tool could be used on a daily basis at home.	Cost of treatment Effectiveness of treatment Cost of preventative care Effectiveness of preventative care
Tricco et al.12 (2015)	Review	Various complex wound interventions	Chronic hard-toheal wounds and pressure ulcers	A total of 22 complex wound interventions were identified to be effective and less expensive compared to other methods.	Rate of healing Cost of treatment Type of treatment Duration of treatment
Whitlock et al.16 (2014)	Cross-sectional study	Various	Chronic wounds and ulcers	Only half of the general practitioners’ time was covered by patient billing. In most cases, the total cost was greater than the total income, resulting in a net loss to the practice.	Cost of treatment

NPWT = negative pressure wound therapy; RCT = randomised controlled trial; DITTO = computerised multimodal procedural preparation and distraction; IGC = intensive glycaemic control; GWC = good wound care; ICU = intensive care unit; QOL = quality of life; 4LB = four-layer bandage; SSB = short-stretch bandage; CME = continuing medical education.