1556 – Human tissue (topical) wound treatments – Ulcers and burns (EpiFix and EpiBurn)

Amendment to MBS item(s).

The proposed medical service is the same as that already listed as:

• MBS Item 30026 - skin and subcutaneous tissue or mucous membrane, repair of wound of, other than wound closure at time of surgery, not on face or neck, small (not more than 7 cm long), superficial
• MBS Item 30029 - skin and subcutaneous tissue or mucous membrane, repair of wound of, other than wound closure at time of surgery, not on face or neck, small (not more than 7 cm long), involving deeper tissue
• MBS Item 45406 - free grafting (split skin) to burns, including excision of burnt tissue - involving not more than 3 per cent of total body surface
• MBS Item 45409 - free grafting (split skin) to burns, including excision of burnt tissue - involving 3 per cent or more but less than 6 per cent of total body surface.

The only difference is the prosthesis used to repair the wound / graft the split skin.

Type: Therapeutic

Although there are a number of wound types covered by this Application, the most common are non-healing diabetic foot ulcers.

Non-healing diabetic foot ulcers

In 2005, over 1000 people with diabetes died as a direct result of lower limb ulceration; this represented 8% of all diabetes-related deaths. Annually, there are about 10 000 hospital admissions for diabetes-related foot ulcers (DRFUs) in Australia, with lower limb amputation a common outcome.

The lifetime risk of a foot ulcer in patients with diabetes (type 1 or 2) may be as high as 25 percent. Diabetic foot ulcers are a major cause of morbidity and mortality, accounting for approximately 85% of amputations performed in Australia. Infected or ischemic diabetic foot ulcers account for approximately 25 percent of all hospital stays for patients with diabetes.

Risk factors that can lead to foot wounds in patients with diabetes include loss of protective sensation due to neuropathy, prior ulcers or amputations, foot deformity leading to excess pressure, external trauma, infection, and the effects of chronic ischemia, typically due to peripheral artery disease. Patients with diabetes also have an increased risk for non-healing related to mechanical and cytogenic factors, as well as a high prevalence of peripheral artery disease.

There are a total of 380,000 people with diabetic foot disease in Australia. It is estimated that there is an average of 1000 people in hospital each day due to diabetic foot disease costing one million dollars each day. 12 people have an amputation procedure each day and there are 4 deaths each day directly resulting from the condition.

The non-healing diabetic foot ulcers covered by this Application are not more than seven centimetres long and can be either superficial or deeper tissue.

Burns

The second medical condition covered by this Application is burns. Based on the current MBS Items, this medical condition can be divided into two groups. Burns covering not more than three per cent of the total body surface and those covering three per cent or more but less than six per cent of the total body surface.

• PASC meeting: 6 to 7 December 2018
• ESC meeting: -
• MSAC meeting: -