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 5 experts were familiar with the technology and 4 out of 5 had used this technology before.

Level of innovation

Four experts stated that Granulox is a novel treatment, 2 of which agreed it is easy to use and more transportable than other technologies. Three experts acknowledged that other oxygen wound therapies are available, for example topical pressurised oxygen therapy, wound dressings releasing oxygen and oxygen diffusion enhancers. One expert felt that Granulox was a variation on existing treatments and was no longer new.

Potential patient impact

Three experts stated that Granulox could promote quicker wound healing by improving oxygenation of the wound bed. One expert said that it could also lower infection rates and improve quality of life. Another stated that it could reduce wound pain. Three experts said that Granulox could be beneficial for people with chronic non-healing wounds and people with microvascular disease. One expert felt that no target group has been established by current research, which could lead to the technology being used inappropriately. Two experts felt that further large-scale studies are needed to determine the efficacy and patient impact of Granulox.

Potential system impact

All 5 experts agreed that Granulox should be used in addition to standard care. Two experts felt that adopting Granulox would not need changes to the existing care pathway. One expert said that applying the product every 3 days may increase the need for podiatry or nursing visits. All experts said that there would be an initial cost to purchase the technology, but 3 experts felt that there could be long-term cost savings because of a reduced number of clinic visits, reduced dressing changes and improved healing outcomes. Two experts felt that there was not enough evidence to determine if Granulox improved wound healing outcomes. All experts thought minimal product training would be needed for staff and people with chronic non-healing wounds before using the technology.

General comments

Four out of the 5 experts said that there were gaps in the research for this technology. Two said that they would like to see studies with larger sample sizes. Two experts stated that they would like to see more controlled comparative studies in specific target populations of wound types, for example diabetic foot ulcers or venous leg ulcers. Two experts said that outcomes in future research should include length of time to wound healing, pain score, quality of life, long-term outcomes and signs of skin deterioration and allergy. Two experts felt that the adoption of Granulox was likely to be slow without a larger evidence base with supporting cost-effectiveness data.