Venous ulcer care: which dressings are cost effective?

Abstract

Healed or open venous ulcers may be present in up to 1% of Western populations and consume a large amount of healthcare resources. These ulcers are characterized by a chronic inflammatory environment with impaired healing and often require months for closure. The average monthly cost of care for an open ulcer has been estimated to be $4095. The fundamental tenets of ulcer care include adequate compression and maintaining a moist wound environment with an appropriate primary dressing. A number of specialized products including semi-occlusive/occlusive, antimicrobial, and advanced wound matrix dressings are now available. However, there is little data from appropriate clinical studies to suggest significantly improved outcomes with any of these dressings. Data regarding their cost-effectiveness is also limited, often conflicting, and subject to bias. At present, there is little solid evidence to guide the choice of primary dressings and a patient-centered approach focusing on characteristics of both the patient and their ulcer, while paying attention to costs, may be most appropriate.

Avaliação da pentoxifilina e do sulfato ferroso no tratamento da úlcera varicosa dos membros inferiores

“… 9 - 12 These results are similar to those found by authors who have reported that pentoxifylline is a satisfactory adjuvant medication for healing of VU of lower limbs, but the data do not prove its efficacy. 28 , 29 …”

“…No entanto, essa redução não teve diferença estatisticamente significativa quando comparados os momentos de avaliação (diagnóstico e após o tratamento) em cada grupo e entre os grupos, apesar de alguns estudos da literatura demonstrarem um efeito positivo significativo da pentoxifilina na cicatrização de úlceras varicosa 9 - 12 . Esses resultados são semelhantes aos encontrados por autores que relataram que a pentoxifilina é uma medicação adjuvante satisfatória na cicatrização das UV de MMII, mas os dados não conseguiram provar a sua eficácia 28 , 29 .…”

Chronic venous disease and venous leg ulcers: An evidence-based update

“…60 Occlusive hydrocolloid dressings have been found to reduce pain and are often preferred by patients because of this effect, the ease of application, and lower cost. 60 Other types of dressings, such as low adherent dressings, are inexpensive but require frequent changes and they control odor and drainage poorly. Hydrofibers and alginates are highly absorbent and well-suited for management of the heavily draining VLUs.…”