Economic evaluation of the treatment of chronic wounds: hydroactive wound dressings in combination with enzymatic ointment versus gauze dressings in patients with pressure ulcer and venous leg ulcer in Germany.

OBJECTIVE: The treatment costs for pressure ulcers and venous leg ulcers were estimated based on the hospital administrator's perspective in Germany. DESIGN: A spreadsheet model using input data from various hospitals in Germany was developed. INTERVENTIONS: Five currently used treatment strategies were analysed: gauze, impregnated gauze, calcium alginate and hydroactive wound dressing with enzymatic ointment. PARTICIPANTS: All cases used for and in the analysis were treated in the inpatient setting (4 hospitals and 120 patients were included). MAIN OUTCOME MEASURES AND RESULTS: The outcome distributions were calculated using the Monte Carlo method. For the whole treatment process, the attributable costs for the hospital were calculated for different cases (severity) and all treatment strategies (1997 values). The costs for treatment with gauze were the highest, whereas the costs for treatment with hydroactive wound dressings and enzymatic ointment were the lowest. The relation between personnel and material costs for gauze is approximately 95 to 5% and for hydroactive wound dressings 67 to 33%, respectively. The cost savings per case were between 1196 deutschmark (DM) and DM9826 using hydroactive wound dressings instead of gauze dressings (depending on the severity of the pressure ulcer), and between DM135 and DM677 for venous leg ulcers. The results were robust and did not change in any performed sensitivity analysis (parameter: 'personnel costs per minute', 'time required for changing a wound dressing', 'total number of wound dressing changes'). CONCLUSIONS: Despite the higher material costs of the hydroactive wound dressings in combination with enzymatic wound cleaning compared with other wound dressings, they should be recommended for the treatment of pressure ulcers and venous leg ulcers. This therapy alternative brings about significant reductions in total costs for hospitals because of significant reductions in personnel costs and the duration of treatment.

The protective effects of a new preparation on wound edges.

OBJECTIVE: This study investigated the effect of Cavilon No Sting Barrier Film (NSBF) (3M Healthcare) on erythema on the edges of highly exuding wounds in patients with venous stasis ulcers. METHOD: An intra-individual double-blind randomised test was performed on 239 patients. The two sides of each wound on each patient were treated with two different dressings: Cavilon NSBF was applied to the wound edges of one side and a control (water) to the edges of the other. Erythema was assessed daily using a chromameter. RESULTS: These are based on the 227 patients who completed the study. The researchers were surprised by their unambiguity: in 88.1% of patients, the erythema completely disappeared within three days of treatment with the test material; in the remaining 11.9% it had completely disappeared after four days. With the control, erythema intensity remained more or less unchanged throughout the four-day observation period. CONCLUSION: This study demonstrates that Cavilon NSBF helped control erythema in all the patients: in 97.3% examined, the measurable and objectively recordable erythema receded within two days.

[Effects of soft bedding on body perception and posture]. / Der Einfluss von Weichlagerung auf die Körperwahrnehmung und -haltung.

This investigation in several hospitals of the Federal Republic of Germany attempts for the first time to demonstrate the effects of soft bedding on the patients' condition on hand of well known and in other disciplines well established criteria. It could be shown that the softness of the mattress causes considerable problems for the patient. Furthermore, it becomes clear that the extent of nursing increases markedly with a very soft bedding of the patient in order to compensate for the disadvantages arising from it. Materials used in the prevention of bed sores (so called antidecubitus mattresses) have to be evaluated critically. Nurses must attempt to determine which kind of mattress ought to be used. If the mobility of the patient is not to be restricted even more, the use of a harder mattress may have to be considered.

[Current aspects of the therapy of chronic wounds]. / Aktuelle Aspekte der Therapie chronischer Wunden.

The therapy of chronic lesions is a matter of debate among both physicians and nursing personnel. Often very different therapeutic approaches are conceivable, which contradict each other to some extent, but which must in any case be prescribed by a physician who is responsible for them. However, carrying out the therapy is often the task of the nursing personnel, who therefore stand in need of thorough information concerning the therapeutic considerations in order to realize these adequately. Here, important, but all too often neglected aspects of therapy are to be described in a summarizing manner.