SAN DIEGO Treatment of stage II pressure ulcers with a self-adhesive polyurethane foam dressing was more cost effective than was treatment with standard saline-soaked gauze, according to a multicenter, randomized trial.
"The current wound care practice in the United States is still dominated by the traditional methods such as saline-soaked gauze or wet-to-dry gauze," Dr. Wyatt G. Payne said in a poster presented at the annual meeting of the Wound Healing Society.
"Many facilities still use this low-technology, low-cost dressing treatment because many practitioners are not fully convinced that advanced wound care products provide fully the benefits they claim, and as such do not warrant the increased costs per dressing. The increased cost per dressing of advanced wound care products leads to the perception that they are expensive, when they may actually be a more cost effective alternative because they need changing less often," he wrote.
Dr. Payne of the Bay Pines VA Healthcare System in St. Petersburg, Fla., and associates, randomized 36 patients with stage II pressure ulcers to receive Allevyn Thin self-adhesive polyurethane foam dressing (Smith & Nephew) or saline-soaked gauze. Each patient was assessed each week for 4 weeks, unless the ulcer closed.
Mean patient age was 73 years and more than half (61%) were men. The mean cost of dressing and other materials for patients in the polyurethane foam dressing group was $32 per week, compared with $58 per week for those in the saline-soaked gauze group. "This implies that a switch from gauze to polyurethane foam would make it possible to treat 80% more patients with the same materials budget," the researchers estimated.
Overall mean treatment cost per week was also lower for patients in the foam-dressing group, $91, compared with a mean of $209 for the saline-soaked gauze group. The savings of $118 per patient "is consistent with a saving in the cost on nursing time of $92 per week," Dr. Payne reported at the meeting, which was held in conjunction with a symposium on advanced wound care.
"This represents more than 3 hours of nursing time per patient per week (assuming a median wage of $28 per hour for a registered nurse)," he wrote.
Dressings were changed a mean of five times per week in the foam-dressing group, compared with a mean of 13 times per week in the saline-soaked gauze group. At the end of 4 weeks, 50% of the wounds in the foam-dressing group were closed, compared with 38% of those in the saline-soaked gauze group, but there was no evidence of a difference between the two groups in time to wound closure.
Total per patient costs over the 4-week evaluation period ranged from $265 to $315 in the foam-dressing group and from $691 to $781 in the saline-soaked gauze group. The number of days free of ulcer was 9 vs. 7, respectively.
Smith & Nephew funded the study. Dr. Payne said that he has no financial interest in the company.
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