Time and labor costs of compression therapy wrap system for lower extremity edema: results from a single center.

INTRODUCTION: Compression therapy is the standard of care for the treatment of lower extremity edema. However, compression therapy systems can be time-consuming to apply, which adds costs to the health care system and further strains human resources. OBJECTIVE: The purpose of this study was to assess time and labor costs associated with the application of a 2LB versus 4LB compression therapy system. MATERIALS AND METHODS: Time and labor cost data associated with the application of a 2LB system for the treatment of lower extremity edema of all etiologies were collected from a single high-volume wound care center located in Dayton, Ohio. The time and labor costs were compared to a 4LB system over the course of a single day (n = 38). RESULTS: The application time and associated costs were 50% lower for the 2LB system. The expected savings of a 2LB compression system over the course of a month was 16:27 hours and $427 compared to a 4LB compression system, and the revenue gain was estimated at $15 210 revenue per month over the course of the month for the practice. CONCLUSION: The use of a 2LB compression system may be associated with substantial time and cost savings compared to a 4LB system.

Effects of hyperbaric oxygen on motor function in children with cerebral palsy.

OBJECTIVE: We conducted a randomized, double-blind, controlled clinical trial to determine whether hyperbaric oxygen (HBO) improves gross motor function in children with cerebral palsy. METHODS: Forty-nine children aged 3 to 8 years with spastic cerebral palsy were randomized to 40 treatments of HBO (100% oxygen at 1.5atm) or hyperbaric air (HBA, 14% oxygen at 1.5atm) over an 8-week period. The primary outcome was the Gross Motor Function Measure (GMFM) global score. Other outcomes included the Pediatric Evaluation of Disability Inventory (PEDI). Assessments were made before and immediately, 3 months, and 6 months after the treatment period. Within-group changes were analyzed with paired t tests or repeated measures analysis of variance. Analysis of covariance was used for between-group comparisons. RESULTS: Forty-six children (24 HBO, 22 HBA) were analyzed at the second interim analysis, which was scheduled to take place when at least half of the required number of patients in each group had completed pre- and post-treatment testing. No changes occurred in the GMFM from pre- to post-treatment in either group or between groups. Statistically significant increases occurred in both groups on the PEDI, with no difference between groups. The study was stopped because the calculated conditional probability of obtaining a difference between groups if the study continued to the end was only between 0.5% and 1.6%. INTERPRETATION: HBO was not effective in improving GMFM scores, and was no more effective than HBA in improving PEDI scores. These results do not support use of HBO as a therapy for cerebral palsy in young children who did not have neonatal hypoxic-ischemic encephalopathy.