Non-healing
(chronic) skin ulcers are most frequently encountered in the elderly and in
patients with diabetes. With the
demographics of both increasing world-wide, chronic ulcers represent a growing
clinical and economic problem. The incidence of diabetes is now
considered to be of world epidemic proportions, affecting 4-8% of the
population in developed countries. The
number of people with diabetes is expected to reach 5 million in the UK, 63
million in USA and 360-552 million world-wide by 2025-2030. This representing an 85% increase since 2003.
Foot ulcer
is a major complication of diabetes, occurring in 10-25% of all patients with
diabetes. Between 10-15% of foot
ulcers result in amputation of a foot or leg. The highest proportion
(47%) of patients hospitalised for the management of diabetes are admitted with
active foot disease or develop a foot ulcer during their stay. It
is estimated that over 52 million diabetic patients presented with foot ulcers
in 2012 world-wide and approximately 61,000 people with diabetes have foot
ulcers at any given time in the UK.
Current
treatments for non-healing diabetic foot ulcers are largely ineffective. Best clinical practice (i.e. wound
debridement and application of antibiotics) is effective in less than 40% of
cases. The recurrence of apparently
healed ulcers is high (70% after 5 years); the development of new ulcers is
common and lower limb amputation is eventually required in 10-15% of patients
with chronic ulcers, this accounting for over 80% of all lower leg
amputations. The overall success rate of
so-called "advanced" wound healing therapies is low, typically providing less
than a 20% added benefit over best practice protocols, whilst their cost is
disproportionately high.
return to home page
|
