title: Economic aspects of biofilm-based wound care in diabetic foot ulcers.
abstract: OBJECTIVE
  There has been a dramatic rise in the number of chronic wounds globally, which is placing an increased demand on decreasing health-care resources. With significant cuts in health-care budgets, wound care, providers will have to achieve better outcomes quicker and with fewer resources. By using new molecular methods to fully identify wound microbiota, commercially available antimicrobials can be used more efficiently, thereby improving outcomes and decreasing cost.
  
  
  METHODS
  This study is a retrospective analysis of patients treated for diabetic foot ulcers (DFU); one group healed DFUs in 2005, the other in 2013. The 2005 patients were treated with standard of care methods common today. The second cohort from 2013 included patients treated using biofilm-based wound management anchored by molecular diagnostics. DNA methods were used to identify individual wound microbiota. Then personalised gels with commercially available antibiotics were applied topically to manage the microorganisms identified.
  
  
  RESULTS
  For the 2013 cohort, total charges per patient for the entire course of treatment was $4,756 (total payments $3,060; £1,987). For the 2005 cohort, each patient required treatments that culminated in total charges of $14,690 (total payments $11,444; £7,429). The economic difference per patient from 2013 compared to 2005 was a reduction in total charges of 68% (reduction in total reimbursement of 73%).
  
  
  CONCLUSIONS
  In conjunction with other cohort analysis we previously reported, we feel this economic data demonstrates the benefits not only in wounds healed faster but also more wounds healed at a greatly reduced total cost.
authors.affiliation: Medical Director of Southwest Regional Wound Care Center; Southwest Regional Wound Care Center, Lubbock, Texas.
authors.forename: R
authors.initials: R
authors.lastname: Wolcott
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D018441:Biofilms; D015331:Cohort Studies; D003362:Cost-Benefit Analysis; D003646:Debridement / Q000191:economics*; D017719:Diabetic Foot / Q000188:drug therapy* / Q000191:economics* / Q000382:microbiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D015206:Southwestern United States; D016896:Treatment Outcome; D014945:Wound Healing; D014947:Wounds and Injuries / Q000188:drug therapy* / Q000191:economics
chemical_list: D000900:Anti-Bacterial Agents
keywords: biofilms; debridement; diabetic foot ulcer; economic costs; health care costs; wound healing