Healthcare Industry News:  Venous Leg Ulcer 

Devices Wound Care Reimbursement

 News Release - November 19, 2009

Smith & Nephew Supports New CPT Code for Multi-Layer Compression Bandaging Systems

ST. PETERSBURG, Fla., Nov. 19 (Healthcare Sales & Marketing Network) -- The Advanced Wound Management division of Smith & Nephew, Inc., a subsidiary of Smith & Nephew plc (LSE: SN ; NYSE: SNN ), supports the American Medical Association's creation of the new Category (1) Current Procedural Terminology (CPT) Code 29581, "Application of multi-layer venous wound compression system, below knee." The new code goes into effect on January 1, 2010.

"Venous Leg Ulcers afflict approximately one percent of all adults in the Western world.(1) These wounds dramatically affect a patient's quality of life and are a common source of morbidity in the elderly," said Tom Dugan, North American President, Smith & Nephew Advanced Wound Management. "Clinically, it is well known that venous ulcers are slow to heal, or fail to heal altogether, without the application of effective, sustained, graduated compression. The application of multi-layer bandaging has long been considered the gold standard treatment for this debilitating condition. (2)

"Smith & Nephew's PROFORE(TM) Multi-Layer High Compression Bandaging System is the market leader in this product category," Mr. Dugan added. "With a dedicated CPT code, multi-layer bandaging will now be more accessible to physicians and patients. We support this decision and believe that it will improve patient access to the standard of care, support sound clinical decision-making and improve patient outcomes for those with this condition."

"Smith & Nephew's multi-layer bandaging portfolio also includes the unique VARI-STRETCH(TM) technology of the PROGUIDE(TM) Two Layer High Compression Bandaging System. These multi-layer compression bandaging systems are part of a complete range of advanced dressings and wound management systems that facilitate appropriate product utilization across the continuum of wound care," said Randall Carson, Director, Government Affairs and Reimbursement, Smith & Nephew Advanced Wound Management. "The treatment of Venous Leg Ulcers alone consumes more than $1 billion in the U.S. annually.(1) Smith & Nephew works hard to provide physicians with therapeutic options that support their clinical judgment and deliver value to their institutions and the health delivery system as a whole. The decision to assign a dedicated CPT code for venous wound compression is an important step towards meeting these goals."

About PROFORE and the Clinical Effectiveness of Four Layer Bandaging Systems

Four-layer compression bandaging systems offer advantages over two-layer systems in terms of reduced withdrawal from treatment, fewer device-related adverse incidents and lower treatment costs for patients with chronic Venous Leg Ulceration.(3) PROFORE(TM) has been proven to close 79% of Venous Leg Ulcers in 12 weeks.(4) In a study in the UK, which compared the cost of PROFORE to "usual care," annual treatment costs were reduced by 38-55% and patient outcomes were improved .(5) In June 2009, the British Medical Journal published a study from five randomized controlled trials of 797 patients, which compared wound closure rates and cost impact of four-layer compression bandaging systems to short stretch bandages in individuals with Venous Leg Ulcers. The study found that four-layer bandaging systems provide faster wound closure of Venous Leg Ulcers and increase the chance of healing by approximately 30%, when independent prognostic factors are considered, as compared to short stretch bandages.(6)

The PROFORE product portfolio includes a full range of options designed to apply effective, sustained, graduated compression on lower legs with various circumferences, and is available in latex-free alternatives. PROGUIDE(TM) is a high compression two-layer bandaging system, offering patients and clinicians additional treatment options with comparable healing rates to PROFORE.(7)

For more information regarding Smith & Nephew, please visit

About Smith & Nephew

Smith & Nephew is a global medical technology business, specializing in Orthopeadics, including Reconstruction, Trauma and Clinical Therapies, Endoscopy and Advanced Wound Management. Smith & Nephew is a global leader in arthroscopy and advanced wound management and is one of the leading global orthopeadics companies.

Smith & Nephew is dedicated to helping improve people's lives. The Company prides itself on the strength of its relationships with its surgeons and professional healthcare customers, with whom its name is synonymous with high standards of performance, innovation and trust. The Company operates in 32 countries around the world. Annual sales in 2008 were nearly $3.8 billion.

Forward-Looking Statements

This press release contains certain "forward-looking statements" within the meaning of the US Private Securities Litigation Reform Act of 1995. In particular, statements regarding expected revenue growth and trading margins discussed under "Outlook" are forward-looking statements as are discussions of our product pipeline. These statements, as well as the phrases "aim", "plan", "intend", "anticipate", "well-placed", "believe", "estimate", "expect", "target", "consider" and similar expressions, are generally intended to identify forward-looking statements. Such forward-looking statements involve known and unknown risks, uncertainties and other important factors (including, but not limited to, the outcome of litigation, claims and regulatory approvals) that could cause the actual results, performance or achievements of Smith & Nephew, or industry results, to differ materially from any future results, performance or achievements expressed or implied by such forward-looking statements. Please refer to the documents that Smith & Nephew has filed with the U.S. Securities and Exchange Commission under the U.S. Securities Exchange Act of 1934, as amended, including Smith & Nephew's most recent annual report on Form 20F, for a discussion of certain of these factors.

All forward-looking statements in this press release are based on information available to Smith & Nephew as of the date hereof. All written or oral forward-looking statements attributable to Smith & Nephew or any person acting on behalf of Smith & Nephew are expressly qualified in their entirety by the foregoing. Smith & Nephew does not undertake any obligation to update or revise any forward-looking statement contained herein to reflect any change in Smith & Nephew's expectation with regard thereto or any change in events, conditions or circumstances on which any such statement is based.


  1. Jones, KR PhD. Why do chronic Venous Leg Ulcers not heal? Journal of Nursing Care Quality 2009; 24(2): 116-124.
  2. Stacey, M et al. The use of compression therapy in the treatment of Venous Leg Ulcers: a recommended management pathway. EWMA 2002; 2(1):9-13.
  3. Moffatt CJ, McCullagh L, et al. Randomized trial of four-layer and two-layer bandage systems in the management of chronic venous ulceration. Wound Repair and Regeneration 2003; 11(3): 166-171.
  4. Moffat CJ, Franks M, Simon, DA et al. Randomized trial comparing two four layer bandage systems in the treatment of Venous Leg Ulceration. Phlebology 1999; 14 (4); 139-142.
  5. Carr L et al. Comparative cost-effectiveness of four-layer bandaging in the treatment of Venous Leg Ulceration. Journal of Wound Care 1999; 8(5): 243-248.
  6. O'Meara et al. Four layer bandage compared with short stretch bandage for Venous Leg Ulcers: systematic review and meta-analysis of randomized controlled trials with data from individual patients. British Medical Journal, 2009; 338; b1344; 1-9
  7. Partsch H. Understanding the pathophysiological effects of compression. Understanding compression therapy. EWMA Position Document, Medical Education Partnership Ltd. 2003: 2-4 (EXPECT Study).

Source: Smith & Nephew

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