Expert comments

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

All 4 experts had used this technology before.

Level of innovation

All 4 experts agreed that WoundExpress is novel in that it is designed to apply intermittent pneumatic compression away from the wound site, and because patients can use it themselves at home. Three experts said the device was a major innovation in care and had the potential to change clinical practice. One felt it would not shift practice but would instead be another treatment option for patients if standard care did not work for them or they could not tolerate it. Experts said the placement of the device eased application and removal and reduced pain and discomfort because there was no need to apply direct pressure to the wound site.

Potential patient impact

Three experts said that WoundExpress could mean better outcomes for people with lower limb oedema and lower limb ulceration when used together with standard care. Two experts said their patients had very positive experiences with it, with reduced pain and wound size. The other 2 experts also said healing rates were better, which can improve outcomes and quality of life, and reduce the need for clinic visits.

Two experts highlighted the benefits of home use: people can independently manage their therapy at their convenience, and take ownership of their long-term condition, which can improve outcomes. One expert said the position of the technology away from the wound site reduced pain and made it easier to apply and remove the device. One expert also said that early intervention with the device could heal venous lower leg ulcers more quickly.

Two experts said that the device could particularly benefit people who cannot use standard compression therapies because of pain. Two said the device can only be used by people with a thigh circumference of up to 73 cm because of the cuff size.

Potential system impact

All experts said that WoundExpress could reduce clinic visits for wound care because people can self‑manage at home, and that it could improve healing rates and reduce length of care. Two said nurse time and consumables needed could also reduce because of a quicker healing time and because chronic wounds could be avoided. Two experts said treatment is likely to cost more because of the initial capital investment in equipment and thigh garments on top of standard care costs.

One expert said a potential infrastructure barrier was single patient thigh cuff garments being made available to buy on prescription. They said another barrier was funding arrangements to buy or hire the devices and whether it would be appropriate for devices to be bought by the user in the future, which is not currently the case. One expert said storage would be needed for the devices and disposable bandages, as well as a system to supply and collect the devices in the community. All experts agreed that the technology is simple and straightforward to use, and minimal training is needed to use it safely and effectively. None of the experts was aware of any safety issues or adverse incidents.

General comments

All experts said there were gaps in the research on this emerging technology. Two said they would like to see longer-term follow-up research to find out if ongoing support is needed, and if there is an increased risk of re-ulceration and oedema when WoundExpress therapy has finished. One expert said more studies were needed to show the device being used independently by the patient. Two experts also said more research was needed in different wounds with different causes, such as diabetic foot ulceration, mixed arterial venous leg ulceration and arterial lower leg wounds. One expert said that because WoundExpress was to be used alongside standard care, the cost benefits were unclear. They suggested that more evidence was needed on the system impacts of the device.

Expert commentators

The following clinicians contributed to this briefing:

  • Karen Staines, director of education and research/clinical lead for wound care, Accelerate CIC. Did not declare any conflicts of interest.

  • Alison Schofield, tissue viability clinical nurse specialist, Northern Lincolnshire and Goole NHS Trust. Received an honorarium for involvement in best practice statement.

  • Dr Leanne Atkin, vascular nurse consultant at The Mid Yorkshire Hospitals NHS Trust. Received an honorarium for involvement in reviewing a patient leaflet about the device as well as for an advisory board meeting relating to venous disease involving WoundExpress.

  • Nicky Ivins, clinical director, Welsh Wound Innovation Centre. Received financial reimbursement for conference attendance, completed a pilot study through a research unit funded by Huntleigh Healthcare and received research funding from Huntleigh Healthcare for an evaluation study.