Hydrocolloid versus saline-gauze dressings in treating pressure ulcers: a cost-effectiveness analysis

The cost effectiveness of using hydrocolloid dressings versus nonsterile saline-gauze wet-to-moist dressings for treatment of pressure ulcers in a long-term care setting was evaluated. During 21 months, 39 subjects were enrolled, and treatment was randomly assigned. Eighty-nine percent of the hydrocolloid subjects and 86% of the saline-gauze subjects healed. Median healing time was shorter for the hydrocolloid group (nine days) than for the saline-gauze group (11 days), although the difference did not reach statistical significance (p = .12). Presence of exudate at baseline was associated with a prolonged time to healing. For the hydrocolloid treatment, the median nursing time was one eighth that of the saline-gauze treatment, but its materials cost was 3.3 times higher. Using local nursing wages, median total cost for treatment with hydrocolloid dressing was $15.58; for the saline gauze, it was $22.65. Using national nursing wages, these costs were $15.90 and $25.31, respectively. The cost savings of the hydrocolloid treatment using local wages did not reach statistical significance. However, using national wages, the cost of the hydrocolloid treatment was significantly less expensive. Nursing home treatment of pressure ulcers was inexpensive overall. Consequently, the absolute cost savings of using hydrocolloid dressings instead of nonsterile saline-gauze dressing, although real, was relatively modest. Physicians can use local nursing wages to calculate the magnitude of savings in their area.