The National Institute for Health and Care Excellence (NICE) has opened its consultation on the use a scanner that can help improve how burns are treated. The draft guidance from the new NICE medical technologies programme provisionally supports the use of moorLDI2-BI, a blood flow imaging device which can help experienced clinicians to assess the severity of burns more accurately.

MoorLDI2-BI benefits patients by helping clinicians 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 which requires a graft, which could reduce the extent of surgery for some people. In addition, moorLDI2-BI is likely to be particularly helpful in diagnosing the depth of burn wounds in patients with dark skin (where dark skin colour is 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.

The draft guidance makes a positive recommendation about the use of moorLDI2-BI when it is used to guide treatment decisions for patients in whom there is uncertainty about the depth and healing potential of burn wounds that have been assessed by experienced clinicians. The device is a mobile laser doppler blood flow imaging system, used externally to monitor the blood flow in the area of skin which has been burned. A low-power laser beam scans the burn wound and generates a colour-coded ‘map' which indicates the level of blood flow in the skin. It can be used in addition to clinical evaluation to guide decisions about the need for surgical treatment of intermediate burn wounds. The surgical procedure for treatment of burn wounds usually involves removing the damaged skin followed by skin grafting.

This draft medical technology guidance was produced by the Medical Technologies Advisory Committee (MTAC), which is part of the Evaluation Pathway Programme for Medical Technologies. 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. The cost saving is based on data relating to specialist burns centres, however MTAC considered that moorLDI2-BI could also offer advantages in burns units.

Dr Carole Longson, Director of the NICE Centre for Health Technology Evaluation, said: “The supportive provisional recommendation for moorLDI2-BI advises that it should be considered for use in patients with burn wounds of intermediate depth. The evidence examined indicates that in conjunction with expert clinical review, this device can help those patients who need surgical treatment for their burn to get it more quickly, whilst helping patients with less severe burns avoid unnecessary procedures. We look forward to receiving comments on our provisional recommendations from health professionals, industry and patient groups to help inform the development of this guidance.”

More information on the medical technology draft guidance consultation is available at mtg2 . The consultation closes on 4 January 2011.

Ends

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Notes to Editors

About the guidance

1. 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).

2. 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.

3. MoorLDI2-BI laser doppler blood flow imaging system is manufactured by Moor Instruments Ltd.

About the Evaluation Pathway Programme for Medical Technologies

4. 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 /guidance/mtg3/resources/medical-technologies-evaluation-programme .

About NICE

5. The National Institute for Health and Care 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.

6. 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.

7. 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

8. 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.