Clinical and Economic Impact of Wound Care Using a Polyurethane Foam Multilayer Dressing.

OBJECTIVE: To study the impact of a newly introduced dressing on efficiency and quality of care in routine clinical practice in a Spanish community setting. DESIGN AND SETTING: An ambispective multicenter observational study was conducted in 24 primary care centers and 6 nursing homes in 4 different Spanish regions. The study was carried out between November 2017 and March 2019. PATIENTS AND INTERVENTION: A total of 128 wounds in 94 patients (primary care, n = 79; nursing home, n = 15) were analyzed before and 4 weeks after switching to the study dressing. OUTCOME MEASURES: Frequency of dressing changes; secondary outcomes were change in the mean wound area and weekly cost and patient and provider satisfaction. MAIN RESULTS: The mean number of dressing changes was significantly reduced with the study dressing from 3.14 ± 1.77 changes per week to 1.66 ± 0.87 (P < .001), a 47.1% reduction in frequency. Wound area significantly reduced from 9.90 ± 19.62 cm to 7.10 ± 24.33 cm. In addition, a 58.7% reduction in weekly costs was achieved with the intervention. Patients and providers agreed that their satisfaction with wound care improved. CONCLUSIONS: The use of the study dressing in routine clinical practice could lead to a major improvement in both efficiency and quality of wound care. Its use could reduce wound care-related costs through improvements in healing and a reduced frequency of dressing changes. It also enhanced the wound care experience from the perspective of both patients and providers.

Eficiencia de un apósito innovador en la cura de heridas: reducción de la frecuencia de cambio y del coste semanal por paciente / The efficiency of an innovative dressing in wound healing: reduction of change frequency and weekly cost per patient

OBJETIVOS: Evaluar el impacto en la frecuencia de cambio de apósito y en el coste del tratamiento de las heridas que tiene la utilización de un apósito de espuma hidrocelular con indicador de cambio y capa enmascaradora de exudado, y valorar la satisfacción del paciente y la opinión del profesional de enfermería con el apósito de estudio frente a los tratamientos previos. METODOLOGÍA: Estudio observacional, ambispectivo, multicéntrico, realizado en atención primaria y sociosanitaria, en cuatro regiones de España. Participaron pacientes con heridas exudativas, en las que se fuera a sustituir apósitos previos por el apósito del estudio (ALLEVYN Life) según práctica clínica habitual. En cada región, se recogieron y analizaron características de las heridas (antigüedad, localización, tratamientos anteriores, área de la herida), frecuencia de cambio de apósito, coste semanal por paciente (apósitos utilizados y tiempo de enfermería dedicado a curas), satisfacción del paciente y opinión del profesional de enfermería. RESULTADOS: Se incluyó un total de 128 heridas (Galicia: 29; País Vasco: 30; Extremadura: 25, y Comunidad Valenciana: 44). Tras 4 semanas de uso del apósito del estudio se redujo significativamente la frecuencia de cambio (29-58%) y el coste semanal por paciente (apósitos utilizados: 11-61%; apósitos + tiempo de enfermería: 27-59%). En la mayoría de regiones, la reducción del área fue superior al 30%. La experiencia global de los pacientes mejoró con el apósito de estudio frente al tratamiento previo, y fue buena o muy buena en el 60-78% de los casos. En todas las regiones, el profesional de enfermería consideró los apósitos ALLEVYN Life superiores en rendimiento global, indicación de idoneidad de cambio y enmascaramiento del exudado. CONCLUSIONES: El uso del apósito con indicador de cambio y capa enmascaradora disminuyó la frecuencia de cambio de apósito, lo que permitió prolongar los intervalos entre visitas y reducir costes asociados. Al mismo tiempo, mejoró la opinión del profesional de enfermería, y aumentó la satisfacción del paciente

OBJECTIVES: To assess the impact on the dressing change frequency and cost of wound management of using a hydrocellular foam dressing with change indicator and exudate masking layer, and to evaluate the patient's satisfaction and nurse's opinion of the study dressing versus previous treatments. METHODS: Observational, ambispective, multicenter study conducted in primary care and social health care, in four regions of Spain. Patients with acute or chronic exuding wounds, in which previous dressings were to be replaced by the study dressing (ALLEVYN Life) according to usual clinical practice, participated. In each region, wound characteristics (evolution period, location, previous dressings, wound area), dressing change frequency, weekly cost per patient (dressings used and nursing time spent), patient satisfaction and nursing staff opinion were collected and analysed. RESULTS: A total of 128 wounds were included (Galicia: 29; Basque Country: 30; Extremadura: 25; and Valencia: 44). After four weeks of use of the study dressing the frequency of change (29-58%) and the weekly cost per patient were significantly reduced (dressings used: 11-61%; dressings + nursing time: 27-59%). In most regions, the area reduction was more than 30%. The overall patient satisfaction with the study dressing was improved, being good or very good in 60-78% of cases. In all regions, nurses considered ALLEVYN Life dressings superior in overall performance, indication of change adequacy and exudate masking. CONCLUSIONS: The use of the dressing with change indicator and masking layer decreased the frequency of dressing changes, allowing for longer intervals between visits and reducing associated costs. At the same time, they improve the opinion of the nursing staff, and increased patient satisfaction

Apósito posquirúrgico convencional frente a apósito interactivo transparente de cura en ambiente húmedo: evaluación comparativa piloto en pacientes quirúrgicos oncológicos / Post-surgical conventional dressing versus interactive moist wound healing dressing: Comparative evaluation in oncological surgical patients

Objetivos: comparar las prestaciones clínicas de un apósito quirúrgico interactivo transparente de cura en ambiente húmedo frente al apósito quirúrgico convencional de gasa y esparadrapo en pacientes quirúrgicos oncológicos de cirugía abdominal. Método: estudio de cohortes prospectivo, realizado en el MD Anderson Cancer Center (Madrid). Se evalúan, de forma piloto, 24 pacientes quirúrgicos oncológicos, intervenidos de cirugía mayor abdominal de las especialidades digestiva y ginecológica. Doce de los pacientes son tratados con el apósito tradicional (Cosmopor(R)) y doce con el apósito interactivo (Opsite(R) Post Op Visible). La muestra se recoge en el segundo semestre del año 2011. Resultados: el apósito interactivo permanece al menos 7 días sobre la herida sin despegarse, frente al apósito convencional que precisa cambios diarios. Esto supone una diferencia en costes de 0,70 Euros en materiales y 24 min menos de enfermería por paciente. Desde el punto de vista clínico, con el apósito interactivo se presentan menos casos de infección de herida quirúrgica (8,3% frente a 33,3%) y de efectos adversos (0 frente a 8,3%), y una mejor valoración por parte de los pacientes y profesionales ante la adhesividad, tolerancia en la ducha y visibilidad de la herida. Conclusiones: la utilización sistemática de apósitos interactivos en heridas quirúrgicas oncológicas permite que aumente la permanencia del apósito sobre éstas, con una reducción de un 75% tanto de las infecciones como de otras complicaciones, y una disminución de costes estimada, basándose en 282 posibles pacientes al año, de 193,17 Euros en materiales, 282 horas de tiempo de enfermería y 71 episodios de infección de herida quirúrgica (IHQ) con una estancia extra de 558 días

Objectives: To compare the clinical performance of a surgical interactive transparent moist environment dressing versus a surgical gauze and tape conventional dressing in oncological abdominal surgical patients. Method: A prospective cohort study conducted at the MD Anderson Hospital (Madrid). Pilot assessment of 24 surgical oncology patients who underwent major abdominal surgery of gastrointestinal and gynecological specialities. Twelve were treated by the conventional dressing (Cosmopor(R)) and twelve by interactive dressing (Opsite(R) Post Op Visible). The sample is collected in the second half of the year 2011. Results: The interactive dressing remains at least 7 days over the wound without being changed, compared with traditional dressing that requires daily change what it means a difference of costs of 0.70 Euros in material resources and 24 min less in nursing time. Under the clinical point of view with the interactive dressing there are less surgical site infection episodes (8.31% vs 33.3%), less other adverse events (0 vs 8.3%) and improved satisfaction amongst patients and healthcare professionals adhesiveness, tolerance in shower and visibility of the wound. Conclusions: The systematic use of interactive postoperative dressings in surgical oncology increases the time of permanence of the dressings on wounds with a reduction of the 75% of surgical site infections and other adverse events reduction, as well as a cost reduction, estimated on a basis of 282 possible admissions per year of 193.17Euros in materials, 282 hours in nursing time, and 71 episodes of surgical site infection with an extra bed occupancy of 558 days