title: A systematic review of cost-effectiveness analyses of complex wound interventions reveals optimal treatments for specific wound types.
abstract: BACKGROUND
  Complex wounds present a substantial economic burden on healthcare systems, costing billions of dollars annually in North America alone. The prevalence of complex wounds is a significant patient and societal healthcare concern and cost-effective wound care management remains unclear. This article summarizes the cost-effectiveness of interventions for complex wound care through a systematic review of the evidence base.
  
  
  METHODS
  We searched multiple databases (MEDLINE, EMBASE, Cochrane Library) for cost-effectiveness studies that examined adults treated for complex wounds. Two reviewers independently screened the literature, abstracted data from full-text articles, and assessed methodological quality using the Drummond 10-item methodological quality tool. Incremental cost-effectiveness ratios were reported, or, if not reported, calculated and converted to United States Dollars for the year 2013.
  
  
  RESULTS
  Overall, 59 cost-effectiveness analyses were included; 71% (42 out of 59) of the included studies scored 8 or more points on the Drummond 10-item checklist tool. Based on these, 22 interventions were found to be more effective and less costly (i.e., dominant) compared to the study comparators: 9 for diabetic ulcers, 8 for venous ulcers, 3 for pressure ulcers, 1 for mixed venous and venous/arterial ulcers, and 1 for mixed complex wound types.
  
  
  CONCLUSIONS
  Our results can be used by decision-makers in maximizing the deployment of clinically effective and resource efficient wound care interventions. Our analysis also highlights specific treatments that are not cost-effective, thereby indicating areas of resource savings. Please see related article: http://dx.doi.org/10.1186/s12916-015-0288-5.
authors.affiliation: Knowledge Translation Program, Li Ka Shing Knowledge Institute, St. Michael's Hospital, 30 Bond Street, Toronto, ON, M5B 1W8, Canada. triccoa@smh.ca.|Epidemiology Division, Dalla Lana School of Public Health, University of Toronto, 155 College Street, Toronto, ON, M5T 3M7, Canada. triccoa@smh.ca.
authors.forename: Andrea C
authors.initials: AC
authors.lastname: Tricco
authors.affiliation: Knowledge Translation Program, Li Ka Shing Knowledge Institute, St. Michael's Hospital, 30 Bond Street, Toronto, ON, M5B 1W8, Canada. cogoe@smh.ca.
authors.forename: Elise
authors.initials: E
authors.lastname: Cogo
authors.affiliation: Knowledge Translation Program, Li Ka Shing Knowledge Institute, St. Michael's Hospital, 30 Bond Street, Toronto, ON, M5B 1W8, Canada. isaranuwatcw@smh.ca.|Institute of Health Policy, Management and Evaluation, University of Toronto, 155 College Street, Toronto, ON, M5T 3M7, Canada. isaranuwatcw@smh.ca.
authors.forename: Wanrudee
authors.initials: W
authors.lastname: Isaranuwatchai
authors.affiliation: Knowledge Translation Program, Li Ka Shing Knowledge Institute, St. Michael's Hospital, 30 Bond Street, Toronto, ON, M5B 1W8, Canada. khanp@smh.ca.
authors.forename: Paul A
authors.initials: PA
authors.lastname: Khan
authors.affiliation: Knowledge Translation Program, Li Ka Shing Knowledge Institute, St. Michael's Hospital, 30 Bond Street, Toronto, ON, M5B 1W8, Canada. geetha.sanmugalingham@alumni.utoronto.ca.
authors.forename: Geetha
authors.initials: G
authors.lastname: Sanmugalingham
authors.affiliation: Knowledge Translation Program, Li Ka Shing Knowledge Institute, St. Michael's Hospital, 30 Bond Street, Toronto, ON, M5B 1W8, Canada. antonyj@smh.ca.
authors.forename: Jesmin
authors.initials: J
authors.lastname: Antony
authors.affiliation: Knowledge Translation Program, Li Ka Shing Knowledge Institute, St. Michael's Hospital, 30 Bond Street, Toronto, ON, M5B 1W8, Canada. hochj@smh.ca.|Institute of Health Policy, Management and Evaluation, University of Toronto, 155 College Street, Toronto, ON, M5T 3M7, Canada. hochj@smh.ca.
authors.forename: Jeffrey S
authors.initials: JS
authors.lastname: Hoch
authors.affiliation: Knowledge Translation Program, Li Ka Shing Knowledge Institute, St. Michael's Hospital, 30 Bond Street, Toronto, ON, M5B 1W8, Canada. sharon.straus@utoronto.ca.|Department of Geriatric Medicine, University of Toronto, 200 Elizabeth Street, Suite RFE 3-805, Toronto, ON, M5G 2C4, Canada. sharon.straus@utoronto.ca.
authors.forename: Sharon E
authors.initials: SE
authors.lastname: Straus
mesh_terms: D000328:Adult; D003362:Cost-Benefit Analysis; D005260:Female; D006801:Humans; D008297:Male; D009656:North America; D014947:Wounds and Injuries / Q000191:economics* / Q000628:therapy*