Just how big is the impact of wounds on Canadians and Canadian health-care systems?
The most common types of wounds relate to:
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Trauma: Intentional (surgery, self-inflicted) and unintentional (accidents)
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Burns (accidental, treatment-related)
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Diabetes (foot)
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Poor venous return (legs)
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Poor arterial flow (legs and other extremities)
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Pressure (sacrum, hips, ears, heels)
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Moisture-associated dermatitis (thighs, skin folds and more)
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Combinations of factors (all locations)
- Skin tears
Many types of wounds are preventable, and efforts in prevention are more cost-effective than waiting until treatment is required. Where wounds do exist early intervention can prevent them from becoming complicated (infected, chronic, dehisced, enlarged). The consequences relating to diabetic foot ulcers make a good case for prevention:
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With early screening, persons with diabetes who are at high risk for developing a foot ulcer could receive appropriate offloading, education and follow-up that will prevent a wound from occurring.
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If left until an ulcer develops, the costs increase significantly over the costs for prevention. The total direct-care cost of diabetic foot ulcers to the Canadian health-care system was determined by Hopkins et al. to be $547 million (2011 dollars), with an average cost per case at $21,371. If the wound becomes chronic, the cost over three years climbs to $52,360.
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Personal and societal costs are significant as well. In a study reported by Hopkins et al., where patients with diabetic foot ulcers were followed for three years, the mortality rate was 26.4%. When a diabetic foot ulcer leads to an amputation, the mortality rate jumps to about 50% at five years.