National Institute for Health and Clinical Excellence (NICE)
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New NICE guidance on scanner to help improve burns treatment
The National Institute for Health and Clinical Excellence (NICE) has recently published its final guidance on the use of a scanner that can help improve how burns are treated. The medical technology guidance supports the use of the moorLDI2-BI, a laser doppler blood flow imaging system for the non-invasive mapping of blood flow in burnt skin which can help experienced clinicians to assess the severity of burns more accurately.
The device uses a low-power laser beam to scan the burn wound and generates a colour-coded ‘map' which indicates the level of blood flow in the skin. This information can help clinicians where there is uncertainty about the depth and healing potential of burn wounds and enables them to identify those with deeper burns, so they can receive skin graft surgery more quickly. It also means that patients with less severe burns can avoid unnecessary surgical treatment. The device can help to accurately define the area of skin requiring a graft, which could reduce the extent of surgery for some people. In addition, the moorLDI2-BI is likely to be particularly helpful in diagnosing the depth of burn wounds in patients with dark skin (due to ethnicity, suntan, birthmarks and tattoos) which can be difficult to assess. It may also be helpful in accurately assessing burn depth and healing time in children, which can be difficult given their thin skin and a prevalence of mixed-depth scald burns.
Dr Carole Longson, Director of the NICE Centre for Health Technology Evaluation, said: “Clinical evaluation of burn wounds is the most widely used method of determining their depth and informing subsequent treatment. The accuracy of clinical evaluation very much depends on the experience of the clinician yet even the most experienced sometimes have difficulty distinguishing the superficial dermal burns that will heal well, from deep dermal burns where a long healing time will lead to unsightly scarring. Today's guidance supporting the use of the moorLDI2-BI for use in patients with burn wounds of intermediate depth recognises its potential for increasing the accuracy of predicting burn wound healing. It also recognises its potential to save the NHS money by enabling earlier and perhaps less extensive surgical treatment in some patients, and avoiding the need for surgery in others.”
This medical technology guidance was produced by the Medical Technologies Advisory Committee (MTAC), which is part of the Medical Technologies Evaluation Programme. This new programme will help enable new medical technologies, or innovative modifications to existing ones, to be used more quickly and consistently in the NHS across England. In particular, MTAC looks at whether a device offers benefits to the patient and NHS at a lower cost compared with similar products, or increased benefits for equal cost. The estimated average cost saving when the moorLDI2-BI is used in addition to clinical evaluation is in the region of £1240 per patient scanned compared with clinical evaluation alone. The cost saving is based on data relating to the burn care services and assumes that 70% of the admitted patients were likely to have intermediate burn wounds and be scanned
Notes to Editors
About the guidance
1. The guidance on the use of the moorLDI2-BI for burn wound assessment is available on the NICE website at http://guidance.nice.org.uk/MT/104
2. The cost models used indicated that the estimated average cost saving when the moorLDI2-BI is used in addition to clinical evaluation is £1248 per patient scanned (if the equipment is purchased) or £1232 per patient scanned (if the equipment is leased).
3. The purchase cost of a moorLDI2-BI system is approximately £50,000 with an annual servicing cost of approximately £8,000, or it can be leased at an inclusive cost of approximately £22,000 per year.
4. MoorLDI2-BI laser doppler blood flow imaging system is manufactured by Moor Instruments Ltd.
About the Medical Technologies Evaluation Programme
5. Established by NICE in 2009, the focus of this new area of work is specifically on the evaluation of innovative medical technologies, including devices and diagnostics. The types of products which might be included are medical devices that deliver treatment such as those implanted during surgical procedures, technologies that give greater independence to patients, and diagnostic devices or tests used to detect or monitor medical conditions. The independent Medical Technology Advisory Committee has two core remits: selecting medical technologies for evaluation by NICE guidance programmes and also developing medical technologies guidance itself. The guidance applies to the NHS in England, and is not mandatory.
More information is available at http://www.nice.org.uk/MT .
6. The National Institute for Health and Clinical Excellence (NICE) is the independent organisation responsible for providing national guidance and standards on the promotion of good health and the prevention and treatment of ill health.
7. NICE produces guidance in three areas of health:
public health - guidance on the promotion of good health and the prevention of ill health for those working in the NHS, local authorities and the wider public and voluntary sector
health technologies - guidance on the use of new and existing medicines, treatments, medical technologies (including devices and diagnostics) and procedures within the NHS
clinical practice - guidance on the appropriate treatment and care of people with specific diseases and conditions within the NHS.
8. NICE produces standards for patient care:
quality standards - these reflect the very best in high quality patient care, to help healthcare practitioners and commissioners of care deliver excellent services
Quality and Outcomes Framework - NICE develops the clinical and health improvement indicators in the QOF, the Department of Health scheme which rewards GPs for how well they care for patients
9. NICE provides advice and support on putting NICE guidance and standards into practice through its implementation programme, and it collates and accredits high quality health guidance, research and information to help health professionals deliver the best patient care through NHS Evidence.