Retrospective comparison of two years in a paediatric burns unit, with and without acticoat as a standard dressing

The Karolinska Burn Unit in Stockholm, Sweden, carried out a retrospective case review in order to compare the cost of the current protocol of care - in place since mid-2002 - with a previous protocol in paediatric burn patients. The study compared the years 2004 and 2007 with the year 2001. 2004 was the first full year in which the unit staff used Acticoat(TM) (Smith & Nephew Wound Management, Hull, England), IntraSite Gel(TM) (idem), and Allevyn Adhesive(TM) (idem) in the treatment of paediatric burns patients. In 2001 the unit used Mepitel(TM) (Molnlycke, Göteborg, Sweden) together with a saline solution and peroxide for cleansing. This study examined differences in both labour and material costs, measured from the hospital's perspective. Our results show that the main impact of the new protocol was on length of stay for hospitalized patients. In 2001 the mean in-patient stay was 12.5 days; in 2004 the mean stay was 5.6 days and, in 2007, 4.5 days (p < 0.001). It is hypothesized that the reason for this significant reduction in length of stay is that most of the patients treated with Acticoat were sent home earlier to be treated as outpatients because there was less need for sedation and/or analgesics, and because the risk of infection was perceived to be less. Pure hospitalization costs per in-patient were approximately Swedish kronor (kr) 67,725 in 2001 (1 kr = approx. € 0.1 or US$ 0.15) and kr 30,305 and kr 24,440 in 2004 and 2007, respectively. This represents a saving of 55% and 64% with respect to 2001 costs.