Specialist commentator comments

Comments on this technology were invited from clinical specialists working in the field. The comments received are individual opinions and do not represent NICE's view.

All 3 specialists were familiar with or had used this technology before.

Level of innovation

All commentators classed LQD Spray as innovative. Commentators thought that the device could help with patient self-care and shared care because of ease of use. No commentators were able to identify a competing wound spray containing chitosan. However, 1 commentator highlighted that there are existing chitosan dressings, but was uncertain if the formation of chitosan was the same as that in LQD Spray. A different commentator identified an available antimicrobial spray, but this differs from LQD Spray because it is oil-based and always needs a secondary dressing.

Potential patient impact

Potential patient benefits identified by commentators included increased patient self-care resulting in empowerment, improved shared care, and reduced reliance on healthcare professionals. Commentators also cited benefits of improved wound healing, a reduced need for a secondary dressing, which could result in less skin irritation or breakdown, and ease of use.

Commentators thought that groups of people who could particularly benefit from LQD Spray included: children, people with multiple dressing sensitivities, chronic wounds, and people when a dressing is not tolerated (such as those who self-harm, people with learning disabilities, autism and sensory difficulties, dementia or burn wounds). One commentator highlighted that the haemostatic properties of LQD Spray could stop bleeding in highly vascularised areas such as the scalp.

Commentators agreed that LQD Spray could change clinical outcomes, and reduce the time associated with patient appointments at GPs, clinics or district nurse home visits. One commentator thought that it may decrease antibiotics because of the antimicrobial properties of the technology. The same commentator thought that clinicians could develop new pathways for high-risk wounds so that LQD Spray could be used first line, for example, in immunocompromised patients.

Potential system impact

Potential system benefits identified by commentators included reduced nurse time if a secondary dressing was not needed, and reduced number of applications because it does not need to be applied daily.

Opinions on the cost of LQD Spray varied. One commentator thought that LQD Spray would cost less if no secondary dressing was needed, but if a secondary dressing was needed, it would cost the same as standard care. Two commentators agreed that there would be fewer costs associated with healthcare demands (fewer secondary dressings), delivery (fewer nurse visits) and specialist care.

All commentators identified potential reduced resource impact with LQD Spray. Commentators highlighted ease of use (it does not need a registered nurse to apply and so can be applied by other team members in wards and care homes) and transferability between care settings, reducing delays in transfers or discharges. Two other commentators identified fewer dressing changes and so less wastage, and fewer community nurse visits and potential for hospital admission avoidance.

One commentator stated that training needed would be basic initial knowledge from a company representative.

General comments

Two commentators were unable to estimate the eligible number of patients. One commentator estimated that 60% to 80% of patients with wounds would be eligible for LQD Spray. The place of LQD Spray in the care pathway was thought to be in addition to standard care or replacing standard care, for example, replacing a dressing that contains chitosan. One commentator highlighted a possible issue with LQD Spray being the time taken for the spray to dry.

Adoption concerns include the need for further evidence. Commentators identified further evidence needed in certain subgroups of patients, for example, those who self-harm. A separate commentator agreed that clinical experience and clinical evidence on LQD Spray is limited.